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General NPI Number Information
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NPI Number | 1548368244
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Entity Type | Organization
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Legal Business Name | OMNI DIABETES CARE, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 504 AUTUMN SPRINGS CT SUITE C25
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City | FRANKLIN
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State | TN
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Zip | 37067-8277
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Country | US
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Telephone | 888-511-2211
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Fax | 800-418-7620
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Provider Business Mailing Address
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Address Line | 504 AUTUMN SPRINGS CT SUITE C25
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City | FRANKLIN
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State | TN
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Zip | 37067-8277
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Country | US
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Telephone | 888-511-2211
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Fax | 800-418-7620
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | DAVID WATSON
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Credential | CPED, LPED
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Telephone | 423-503-0609
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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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