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General NPI Number Information
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NPI Number | 1114151925
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Entity Type | Organization
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Legal Business Name | HEAVENLY DIABETIC SUPPLIES INC.
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 3700 FREDRICKSBURG RD SUITE # 230
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City | SAN ANTONIO
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State | TX
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Zip | 78201-3269
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Country | US
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Telephone | 210-733-7697
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Fax | 210-733-5843
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Provider Business Mailing Address
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Address Line | 3700 FREDRICKSBURG RD SUITE # 230
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City | SAN ANTONIO
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State | TX
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Zip | 78201-3269
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Country | US
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Telephone | 210-733-7697
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Fax | 210-733-5843
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. HORTENCIA MOYERS
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Credential |
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Telephone | 210-779-8697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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