Organization Name: | DIABETIC EQUIPMENT AND SUPPLIES LLC |
NPI Number: | 1255740387 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHY KAY CARLSON (PRESIDENT & CEO) |
Mailing Address: | 7401 Nw 107th St Grimes |
State: | IA US |
Postal Code: | 501114984 |
Phone Number: | 5154783600 |
Fax Number: | |
NPI Enumeration Date: | 08/02/2014 |
NPI Last Update Date: | 10/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |