Organization Name: | WESTERN DIABETIC SUPPLY CORPORATION |
NPI Number: | 1427015718 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN PLUMB (COO) |
Mailing Address: | 3293 Harrison Blvd Suite 210 Ogden |
State: | UT US |
Postal Code: | 844031226 |
Phone Number: | 8779378342 |
Fax Number: | 8668083418 |
NPI Enumeration Date: | 04/28/2006 |
NPI Last Update Date: | 03/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1005116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |