MEDICARE: ABBOT DIABETES CARE 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	:	1639683329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBOT DIABETES CARE INC

Provider Business Mailing Address
First Line	:	1420 HARBOR BAY PARKWAY
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502
Country	:	US
Telephone Number	:	510-749-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 HARBOR BAY PKWY
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-7080
Country	:	US
Telephone Number	:	510-749-5400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JARED WATKIN
Credential	:
Telephone Number	:	510-864-4457

Provider Enumeration Date	:	11/17/2017
Last Update Date	:	06/21/2018

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