Provider Demographics
NPI:1922830074
Name:DAMASCO
Entity type:Organization
Organization Name:DAMASCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISTABRAQ
Authorized Official - Middle Name:R
Authorized Official - Last Name:MUHIDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-447-4852
Mailing Address - Street 1:941 HILLWIND RD NE STE 100A
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-5963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:941 HILLWIND RD NE STE 100A
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5963
Practice Address - Country:US
Practice Address - Phone:763-657-0637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies