Ambassador Diabetic Supplies and Services, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

AMBASSADOR DIABETIC SUPPLIES AND SERVICES, LLC

Practice address

1220 Knox Abbott Dr
Suite F
Cayce, SC 29033-3350

Phone

(803) 794-4545

Fax

(803) 794-4522

NPI assigned

Jun 10, 2006

Last updated

Apr 20, 2008By 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

Mr. John Lovett Jr.

Title

President Ceo

Phone

(803) 794-4545

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1073554911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 KNOX ABBOTT DR",
            "address_2": "SUITE F",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333350",
            "telephone_number": "803-794-4545",
            "fax_number": "803-794-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 KNOX ABBOTT DR",
            "address_2": "SUITE F",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333350",
            "telephone_number": "803-794-4545",
            "fax_number": "803-794-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR DIABETIC SUPPLIES AND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LOVETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "803-794-4545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2530",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2628811",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.