Healthcare Provider Details

I. General information

NPI: 1831292622
Provider Name (Legal Business Name): NIPRO DIABETES SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 ENTERPRISE WAY
MIRAMAR FL
33025-3932
US

IV. Provider business mailing address

3361 ENTERPRISE WAY
MIRAMAR FL
33025-3932
US

V. Phone/Fax

Practice location:
  • Phone: 954-435-5665
  • Fax: 954-241-0831
Mailing address:
  • Phone: 954-435-5665
  • Fax: 954-241-0831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number07 547
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 21268
License Number StateFL

VIII. Authorized Official

Name: MR. IRA SCHULMAN
Title or Position: PHARMACY MANAGER
Credential:
Phone: 954-435-5665