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General NPI Number Information
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NPI Number | 1851457147
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Entity Type | Organization
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Legal Business Name | ACCURATE DIABETIC SUPPLY, INC.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 117 SE MONTGOMERY PL
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City | LAKE CITY
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State | FL
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Zip | 32025-6288
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Country | US
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Telephone | 386-752-3837
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Fax | 386-758-9969
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Provider Business Mailing Address
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Address Line | 117 SE MONTGOMERY PL
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City | LAKE CITY
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State | FL
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Zip | 32025-6288
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Country | US
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Telephone | 386-752-3837
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Fax | 386-758-9969
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEVEN L MOORE
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Credential |
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Telephone | 386-344-4376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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