MEDICARE: EZ DIABETIC SUPPLIES, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	047029	OTHER	ME	ANTHEM BCBS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689677023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZ DIABETIC SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	61 STATE RD
Second Line	:
City	:	WEST BATH
State	:	ME
Zip	:	04530-6301
Country	:	US
Telephone Number	:	207-386-1080
Fax Number	:	207-386-1088

Provider Business Practice Location Address
First Line	:	61 STATE RD
Second Line	:
City	:	WEST BATH
State	:	ME
Zip	:	04530-6301
Country	:	US
Telephone Number	:	207-386-1080
Fax Number	:	207-386-1088

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ELLIOT M. ZIMMERMAN
Credential	:
Telephone Number	:	207-386-1080

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	04/25/2012

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MEDICARE: EZ DIABETIC SUPPLIES, INC.

Scope of Practice

Other Identifiers

General Provider Information

Similar Medicare Providers

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