=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235073370
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIABETIC SUPPLIES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2026
-----------------------------------------------------
Last Update Date | 04/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 140 S BROAD ST
-----------------------------------------------------
City | CANFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44406-1403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-565-8991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1335 DUBLIN RD # 206B
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43215-1000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-756-6574
-----------------------------------------------------
Fax | 877-288-2520
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | GENIA TRAKHTENBERG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-481-9841
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------