Provider Demographics
NPI:1063787471
Name:DASCO RIVER VALLEY HOME MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:DASCO RIVER VALLEY HOME MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-901-2226
Mailing Address - Street 1:375 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-1400
Mailing Address - Country:US
Mailing Address - Phone:614-901-2226
Mailing Address - Fax:
Practice Address - Street 1:425 W FIFTH ST
Practice Address - Street 2:ROOM W-162
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2405
Practice Address - Country:US
Practice Address - Phone:800-892-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies