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General NPI Number Information
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NPI Number | 1699868380
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Entity Type | Organization
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Legal Business Name | DIABETIC SOLUTIONS LLC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 240 N MORTON ST
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City | SHIPSHEWANA
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State | IN
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Zip | 46565
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Country | US
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Telephone | 877-686-3600
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Fax | 260-768-4111
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Provider Business Mailing Address
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Address Line | P.O. BOX 1081 305 E MAIN ST
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City | SHIPSHEWANA
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State | IN
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Zip | 46565
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Country | US
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Telephone | 877-686-3600
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Fax | 260-768-4111
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Authorized Official
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Title or Position | OWNER
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Name | JARED BALLOU
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Credential |
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Telephone | 877-686-3600
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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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