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General NPI Number Information
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NPI Number | 1528072428
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Entity Type | Organization
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Legal Business Name | CAPITAL DIABETIC SUPPLY, INC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1109 BELLEVIEW ST SUITE 101
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City | COLUMBIA
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State | SC
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Zip | 29201-1839
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Country | US
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Telephone | 803-771-4410
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Fax | 803-771-4460
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Provider Business Mailing Address
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Address Line | 1109 BELLEVIEW ST SUITE 101
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City | COLUMBIA
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State | SC
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Zip | 29201-1839
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Country | US
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Telephone | 803-771-4410
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Fax | 803-771-4460
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES THOMPSON
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Credential |
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Telephone | 803-771-4410
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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 | SC
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