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General NPI Number Information
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NPI Number | 1356559611
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Entity Type | Organization
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Legal Business Name | DIABETES SPECIALTY CENTER LLC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 615 ARAPEEN DR SUITE 100
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-1267
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Country | US
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Telephone | 801-587-3670
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Fax | 801-587-3669
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Provider Business Mailing Address
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Address Line | 3793 S STATE ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-4828
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Country | US
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Telephone | 801-268-9699
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Fax | 801-268-9929
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Authorized Official
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Title or Position | CUSTOMER SERVICE MANAGER COMPLIANCE
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Name | MS. KARLA G MCGUIGAN
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Credential |
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Telephone | 801-268-9699
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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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