MEDICARE: NATIONAL DIABETIC SUPPLIES GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1235279068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL DIABETIC SUPPLIES GROUP, INC

Provider Business Mailing Address
First Line	:	5501 W WATERS AVE
Second Line	:	SUITE 400
City	:	TAMPA
State	:	FL
Zip	:	33634-1229
Country	:	US
Telephone Number	:	813-249-2187
Fax Number	:	813-887-4148

Provider Business Practice Location Address
First Line	:	5501 W WATERS AVE
Second Line	:	SUITE 400
City	:	TAMPA
State	:	FL
Zip	:	33634-1229
Country	:	US
Telephone Number	:	813-249-2187
Fax Number	:	813-887-4148

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CAROLYN L SUESS
Credential	:
Telephone Number	:	813-249-2187

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/22/2020

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