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General NPI Number Information
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NPI Number | 1497780969
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Entity Type | Organization
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Legal Business Name | DIABETIC SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 19837 S MAIN ST
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City | CORNELIUS
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State | NC
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Zip | 28031-8515
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Country | US
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Telephone | 704-892-2800
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Fax | 704-892-2804
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Provider Business Mailing Address
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Address Line | 19837 S MAIN ST
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City | CORNELIUS
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State | NC
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Zip | 28031-8515
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Country | US
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Telephone | 704-892-2800
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Fax | 704-892-2804
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Authorized Official
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Title or Position | OWNER
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Name | MR. MAX L. FORD
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Credential | CFO
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Telephone | 704-892-2800
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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 | 00986
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License Number State | NC
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