MEDICARE: DCI HOLDINGS, 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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1407200041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DCI HOLDINGS, INC

Provider Business Mailing Address
First Line	:	3414 RAINBOW PKWY
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-3204
Country	:	US
Telephone Number	:	256-622-0741
Fax Number	:	256-467-4605

Provider Business Practice Location Address
First Line	:	3414 RAINBOW PKWY
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-3204
Country	:	US
Telephone Number	:	256-622-0741
Fax Number	:	256-467-4605

Authorized Official
Title or Position	:	CEO/CHEMIST
Name	:	MR. STEPHEN PAUL HARP
Credential	:	M.S
Telephone Number	:	256-622-0741

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	04/20/2016

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