MEDICARE: DALES MEDICAL SUPPLY 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	:	1962862292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALES MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	2168 SAINT STEPHENS RD
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36617-3732
Country	:	US
Telephone Number	:	251-471-2113
Fax Number	:

Provider Business Practice Location Address
First Line	:	2168 SAINT STEPHENS RD
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36617-3732
Country	:	US
Telephone Number	:	251-471-2113
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTONIO D DALE
Credential	:
Telephone Number	:	251-441-7744

Provider Enumeration Date	:	02/29/2016
Last Update Date	:	08/02/2016

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