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General NPI Number Information
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NPI Number | 1679557342
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Entity Type | Organization
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Legal Business Name | DIABETES SUPPLY OF CHARLOTTE
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11601 ASBURY CHAPEL RD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4631
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Country | US
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Telephone | 704-948-9075
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Fax | 704-948-1509
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Provider Business Mailing Address
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Address Line | 11601 ASBURY CHAPEL RD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4631
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Country | US
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Telephone | 704-948-9075
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Fax | 704-948-1509
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PAMELA L SPARROW
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Credential |
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Telephone | 704-948-9075
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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 | NC
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