101 Diabetic Supplies, LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Titusville, FL

NPI 1003101296 · NPPES record last updated Aug 23, 2013

Key facts

NPI
1003101296
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
101 DIABETIC SUPPLIES, LLC
Practice address
1400 White Dr Ste B
Titusville, FL 32780-9657
Phone
(321) 676-8989
NPI assigned
Jun 15, 2011
Organization subpart
No

Authorized official

Name
Mr. Dale Greyslak
Title
Managing Member
Phone
(321) 267-7576

National Provider Directory

Locations

2441 Bellevue Ave
#F
Daytona Beach, FL 32114
Phone (855) 636-4603

1400 White Dr
Ste B
Titusville, FL 32780
Phone (321) 676-8989

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

1400 White Dr Ste B
Titusville, FL 32780-9657

Mailing address

1400 White Dr Ste B
Titusville, FL 32780-9657
Phone (321) 676-8989

Other names

  • Jade Diabetic Group Former legal business name

Other providers in Titusville, FL

All providers in Titusville, FL · Durable Medical Equipment & Medical Supplies in Florida

Sources for this page

Verify at the official NPI Registry.