Provider Demographics
NPI:1194759639
Name:DAYVAULT'S HOME MEDICAL INC.
Entity type:Organization
Organization Name:DAYVAULT'S HOME MEDICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-837-2330
Mailing Address - Street 1:350 PINE ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-2437
Mailing Address - Country:US
Mailing Address - Phone:409-832-7013
Mailing Address - Fax:203-702-6840
Practice Address - Street 1:1254 26TH ST SE
Practice Address - Street 2:BLDG 9
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-7317
Practice Address - Country:US
Practice Address - Phone:828-754-1655
Practice Address - Fax:203-702-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704126Medicaid
NC7704126Medicaid