Provider Demographics
NPI:1588787709
Name:MD DALTON HEALTHCARE INC.
Entity type:Organization
Organization Name:MD DALTON HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, BS
Authorized Official - Phone:440-632-1598
Mailing Address - Street 1:15065 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9022
Mailing Address - Country:US
Mailing Address - Phone:440-632-1598
Mailing Address - Fax:
Practice Address - Street 1:15065 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9022
Practice Address - Country:US
Practice Address - Phone:440-632-1598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies