MEDICARE: DIABETIC - DME MAILERS 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	:	1255325924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABETIC - DME MAILERS INC

Provider Business Mailing Address
First Line	:	6550 GRIFFIN RD
Second Line	:	SUITE 102
City	:	DAVIE
State	:	FL
Zip	:	33314-4328
Country	:	US
Telephone Number	:	954-518-0966
Fax Number	:	954-518-0967

Provider Business Practice Location Address
First Line	:	6550 GRIFFIN RD
Second Line	:	SUITE 102
City	:	DAVIE
State	:	FL
Zip	:	33314-4328
Country	:	US
Telephone Number	:	954-518-0966
Fax Number	:	954-518-0967

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KRYSTLE ROSE LIVINGSTON
Credential	:
Telephone Number	:	954-518-0966

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	01/02/2008

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