MEDICARE: DIABETES CARE & EDUCATION, 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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1992989198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABETES CARE & EDUCATION, INC

Provider Business Mailing Address
First Line	:	10101 LINN STATION RD
Second Line	:	SUITE 560
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-3848
Country	:	US
Telephone Number	:	502-412-3253
Fax Number	:	502-412-3202

Provider Business Practice Location Address
First Line	:	3722 BRIDGES ST
Second Line	:	SUITE 2C
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2944
Country	:	US
Telephone Number	:	252-247-3300
Fax Number	:	252-247-3390

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GLENN PARKER
Credential	:	M.D
Telephone Number	:	954-903-5245

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	12/24/2007

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