1003971961 NPI number — DAL, INC

Table of content: (NPI 1003971961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003971961 NPI number — DAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAL, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BARNSTABLE FAMILY CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003971961
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYANNIS PORT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02647-0563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-790-0606
Provider Business Mailing Address Fax Number:
508-790-0808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
677 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYANNIS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02601-3493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-790-0606
Provider Business Practice Location Address Fax Number:
508-790-0808
Provider Enumeration Date:
12/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVEEN
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-790-0606

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 694479 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110083902A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: Y39666 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: DP9454 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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