MEDICARE: LIFESTYLE DIABETIC SUPPORT SERVICES, 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	291U00000X	Clinical Medical Laboratory		IL
2	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician

General Provider Information

NPI Number	:	1881025369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE DIABETIC SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	10210 N 32ND ST STE C7
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3826
Country	:	US
Telephone Number	:	602-675-1576
Fax Number	:	602-610-5844

Provider Business Practice Location Address
First Line	:	10210 N 32ND ST STE C7
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3826
Country	:	US
Telephone Number	:	602-675-1576
Fax Number	:	602-610-5844

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY JOSEPH YOUKHANA
Credential	:	PHARM D
Telephone Number	:	602-675-0887

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	09/09/2020

Similar Medicare Providers

1942480777 — DR. JENNIFER LEE DYE NMD
Practice Location Address:

10210 N 32ND ST STE C5
PHOENIX, AZ
85028-3826

Practice Phone: 480-448-8888
Practice Fax: 844-391-7650

1073006557 — MARY & JOSEPH FOOD AND DRUG COMPANY, LLC
Practice Location Address:

10210 N 32ND ST STE C7
PHOENIX, AZ
85028-3826

Practice Phone: 602-675-0887
Practice Fax: 602-610-5844

1487254918 — ASSYRIAN FAMILY HEALTH ALLIANCE
Practice Location Address:

10210 N 32ND ST STE C6
PHOENIX, AZ
85028-3826

Practice Phone: 602-675-1554
Practice Fax: 602-610-5844

1801017348 — MRS. AIDA C VILAR RN
Practice Location Address:

1310 S 15TH AVE
PHOENIX, AZ
85007-3826

Practice Phone: 602-452-6851
Practice Fax: 602-257-2915

1336474865 — ARLA ANN YODER ZELEDON RN
Practice Location Address:

1310 S 15TH AVE
PHOENIX, AZ
85007-3826

Practice Phone: 602-452-6851
Practice Fax:

1649690553 — VANESSA VIDALES QUINTANA
Practice Location Address:

3826 W BERYL AVE
PHOENIX, AZ
85051-1138

Practice Phone: 760-212-9128
Practice Fax:

Directions to “LIFESTYLE DIABETIC SUPPORT SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.