Prodigy Diabetes Care, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRODIGY DIABETES CARE, LLC

Practice address

2701 Hutchison McDonald Rd Ste a
Charlotte, NC 28269-4276

Phone

(704) 285-6437

NPI assigned

Mar 27, 2018

Organization subpart

No

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

Authorized official

Name

Greg Miller

Title

Coo & VP of Finance

Phone

(704) 285-6437

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1104321793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HUTCHISON MCDONALD RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694276",
            "telephone_number": "704-285-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HUTCHISON MCDONALD RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694276",
            "telephone_number": "704-285-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY DIABETES CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "COO & VP OF FINANCE",
        "authorized_official_telephone_number": "704-285-6437"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.