Wva Diabetic Supplies LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

2223-3336 Issued in WV

Legal business name

WVA DIABETIC SUPPLIES LLC

Practice address

409 S Pike St
Shinnston, WV 26431-1125

Phone

(304) 592-1870

Fax

(304) 592-1890

NPI assigned

Apr 28, 2009

Last updated

Nov 30, 2012By 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. Debra Marie Price

Title

Owner/Manager

Phone

(304) 592-3340

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Butcher, CFTS

  • Pedorthist
  • Shinnston, WV
  • NPI 1194179648
  NPD (past)

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1215171764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S PIKE ST",
            "city": "SHINNSTON",
            "state": "WV",
            "postal_code": "264311125",
            "telephone_number": "304-592-1870",
            "fax_number": "304-592-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 S PIKE ST",
            "city": "SHINNSTON",
            "state": "WV",
            "postal_code": "264311125",
            "telephone_number": "304-592-1870",
            "fax_number": "304-592-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVA DIABETIC SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "304-592-3340",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WV",
            "license": "2223-3336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810015096",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Diana Wallo
• Melody Waybright
• Adam T West, P.T.
• Connie Wolfe
• Noah Woods
• Elizabeth Wyne
• Sarah Rachel Zeh

• Prosthetic/Orthotic Supplier in Shinnston, WV
• Providers in Shinnston, WV by specialty
• Prosthetic/Orthotic Supplier in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.