Basic Information
| Provider Information | |||||||||
| NPI: | 1225505589 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OADC DME LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1910 SOUTH RD | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126016027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454540120 | ||||||||
| FaxNumber: | 8456869016 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 SOUTH RD | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126016027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454540120 | ||||||||
| FaxNumber: | 8456869016 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2018 | ||||||||
| LastUpdateDate: | 10/25/2018 | ||||||||
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| AuthorizedOfficialLastName: | CHACH | ||||||||
| AuthorizedOfficialFirstName: | MARIBETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 8454540120 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.