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General NPI Number Information
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NPI Number | 1225081847
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Entity Type | Organization
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Legal Business Name | CAROLINA DIABETIC SUPPLY, INC.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 DOCTORS CIR
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City | COLUMBIA
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State | SC
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Zip | 29203-6503
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Country | US
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Telephone | 803-931-0953
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Fax | 803-931-0954
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Provider Business Mailing Address
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Address Line | PO BOX 3308
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City | COLUMBIA
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State | SC
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Zip | 29230-3308
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Country | US
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Telephone | 803-931-0953
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Fax | 803-931-0954
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | MR. CURTIS RANKINS
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Credential |
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Telephone | 803-931-0953
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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 | SC
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