Organization Name: | DIABETIC HEALTH SUPPLY, INC |
NPI Number: | 1750385035 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNN C REDAVID (PRESIDENT/CUSTOMER SERVICE MANAGER) |
Mailing Address: | 9031 Pittsburgh Blvd Fort Myers |
State: | FL US |
Postal Code: | 339677206 |
Phone Number: | 2394374004 |
Fax Number: | 2394374008 |
NPI Enumeration Date: | 06/02/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 5282130001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |