Provider Demographics
NPI:1538237607
Name:DOMARI INC.
Entity type:Organization
Organization Name:DOMARI INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMENIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-585-2308
Mailing Address - Street 1:1107 N CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6833
Mailing Address - Country:US
Mailing Address - Phone:610-585-2308
Mailing Address - Fax:610-738-8375
Practice Address - Street 1:1107 N CHESTER RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6833
Practice Address - Country:US
Practice Address - Phone:610-585-2308
Practice Address - Fax:610-738-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019582000001Medicaid
NJ0582500OtherJACC CAP PROVIDER