Provider Demographics
NPI:1528086410
Name:DACAR DURABLE AND MEDICAL SUPPLIES
Entity type:Organization
Organization Name:DACAR DURABLE AND MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-252-2301
Mailing Address - Street 1:120 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4611
Mailing Address - Country:US
Mailing Address - Phone:304-252-2301
Mailing Address - Fax:304-252-2302
Practice Address - Street 1:120 MAIN ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4611
Practice Address - Country:US
Practice Address - Phone:304-252-2301
Practice Address - Fax:304-252-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5430010001Medicare ID - Type Unspecified