Diabetic Supply & Support Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26639 Issued in FL

Legal business name

DIABETIC SUPPLY & SUPPORT INC.

Practice address

10365 Hood Rd S
Suite 103
Jacksonville, FL 32257-3259

Phone

(904) 448-3336

NPI assigned

Jul 12, 2006

Last updated

Apr 13, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Holly Nicole Waldrop

Title

President

Phone

(904) 448-3336

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1033134952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 HOOD RD S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573259",
            "telephone_number": "904-448-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10365 HOOD RD S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573259",
            "telephone_number": "904-448-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SUPPLY & SUPPORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "WALDROP",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-448-3336",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0319889900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606524935A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fatima Dhanani, DMD
• Sarfaraz Shiraz Dhanji, MD
• Swati Dhungel, M.D.
• Stephanie Di Ianni
• Diabetes Supply Program,Inc.
• Diabetico Internacional, Inc. (Do Well Medical Center)
• Diagnostic Cardiology PA
• Rohan Anil Dial, MD
• Dialogical Interaction Recovery, Corp.
• Dialysis Clinic Inc (DCI Jacksonville Mid-Town)

• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.