MEDICARE: DOLLARISLAND INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1275556615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLLARISLAND INC

Provider Business Mailing Address
First Line	:	7590 HAVERFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19151-2113
Country	:	US
Telephone Number	:	215-877-1707
Fax Number	:	215-877-1707

Provider Business Practice Location Address
First Line	:	7590 HAVERFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19151-2113
Country	:	US
Telephone Number	:	215-877-1707
Fax Number	:	215-877-1707

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID GAGOSHIDZE
Credential	:
Telephone Number	:	267-210-0479

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/22/2020

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Directions to “DOLLARISLAND INC ” Practice Location

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