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General NPI Number Information
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NPI Number | 1396914792
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Entity Type | Organization
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Legal Business Name | DIABETIC MEDIC,LLC
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 2265 ROSWELL RD SUITE 100
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City | MARIETTA
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State | GA
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Zip | 30062-2997
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Country | US
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Telephone | 770-783-1043
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Fax | 866-496-8070
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Provider Business Mailing Address
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Address Line | 2265 ROSWELL RD SUITE 100
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City | MARIETTA
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State | GA
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Zip | 30062-2997
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Country | US
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Telephone | 770-783-1043
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Fax | 866-496-8070
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Authorized Official
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Title or Position | MANAGER
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Name | CATHIEA ROBINSON
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Credential |
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Telephone | 770-783-1043
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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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