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General NPI Number Information
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NPI Number | 1407748395
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Entity Type | Organization
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Legal Business Name | DIABETES SPECIALITY CARE AND ASSOCIATES LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 3815 HIGHWAY 66 S STE 5
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City | ROGERSVILLE
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State | TN
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Zip | 37857-5197
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Country | US
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Telephone | 423-293-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 HIGHWAY 66 S STE 5
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City | ROGERSVILLE
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State | TN
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Zip | 37857-5197
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Country | US
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Telephone | 423-293-0202
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Fax | 423-293-0102
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Authorized Official
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Title or Position | CREDENTIALING
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Name | PAMELA ANNE REINERS
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Credential |
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Telephone | 731-571-9223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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