MEDICARE: DIABETIC SOLUTIONS, 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	:	1699723312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABETIC SOLUTIONS, INC

Provider Business Mailing Address
First Line	:	6344 EDGEMERE BLVD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-3517
Country	:	US
Telephone Number	:	915-881-0800
Fax Number	:	915-881-0803

Provider Business Practice Location Address
First Line	:	6344 EDGEMERE BLVD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-3517
Country	:	US
Telephone Number	:	915-881-0800
Fax Number	:	915-881-0803

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAIME ARTURO NOLASCO
Credential	:
Telephone Number	:	915-881-0800

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	11/17/2018

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