MEDICARE: CAROLINA DIABETIC SOLUTIONS LLC

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

General Provider Information

NPI Number	:	1841360575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA DIABETIC SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	14323 OCEAN HWY # 17
Second Line	:	SUITE 4121 LITCHFIELD EXCHANGE
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-4817
Country	:	US
Telephone Number	:	843-421-7739
Fax Number	:

Provider Business Practice Location Address
First Line	:	14323 OCEAN HWY # 17
Second Line	:	SUITE 4121 LITCHFIELD EXCHANGE
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-4817
Country	:	US
Telephone Number	:	843-421-7739
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL PATRICK POWERS SR.
Credential	:
Telephone Number	:	843-421-7739

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	03/26/2008

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