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General NPI Number Information
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NPI Number | 1891840047
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Entity Type | Organization
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Legal Business Name | ACCESS DIABETIC SUPPLY
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 1801 W SAMPLE RD
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City | POMPANO BEACH
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State | FL
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Zip | 33064-1323
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Country | US
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Telephone | 954-975-2281
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Fax | 800-477-5801
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Provider Business Mailing Address
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Address Line | PO BOX 28545
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City | MIAMI
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State | FL
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Zip | 33102-8545
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Country | US
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Telephone | 954-975-2281
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Fax | 800-477-5801
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Authorized Official
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Title or Position | DIVISION PRESIDENT
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Name | WILLIAM K. STOCKSDALE
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Credential |
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Telephone | 954-975-2281
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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 | FL
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