Active NPI
Diabetes Specialty Center LLC
- Durable Medical Equipment & Medical Supplies
- Provo, UT
National Provider Identifier
1245484906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- DIABETES SPECIALTY CENTER LLC
- Practice address
- 1254 N State St
Provo, UT 84604-6432 - Phone
- (801) 392-2362
- Fax
- (801) 392-5643
- NPI assigned
- Nov 7, 2008
- Organization subpart
- Yes
- Parent organization
- DIABETES SPECIALTY CENTER, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Marc Cohen
- Title
- President
- Phone
- (801) 743-2800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary | ||
| Prosthetic/Orthotic Supplier | 335E00000X |
Addresses
Primary practice location
1254 N State St
Provo, UT 84604-6432
Mailing address
3793 S State St
Salt Lake City, UT 84115-4828
Phone (801) 392-2362
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5386155 | Medicaid | UT | |
| 1841279155 | Other | UT | MEDICARE NPI |
National Provider Directory
National Provider Directory- Part of
- Diabetes Specialty Center
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Downers Grove, IL
- NPI 1053366740
Member Of
Locations
1254 N State St
Provo, UT 84604
Phone (801) 337-1487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331856000000",
"number": "1245484906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3793 S STATE ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841154828",
"telephone_number": "801-392-2362",
"fax_number": "801-392-5643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 N STATE ST",
"city": "PROVO",
"state": "UT",
"postal_code": "846046432",
"telephone_number": "801-392-2362",
"fax_number": "801-392-5643"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIABETES SPECIALTY CENTER LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DIABETES SPECIALTY CENTER, LLC",
"enumeration_date": "2008-11-07",
"last_updated": "2012-03-16",
"status": "A",
"authorized_official_last_name": "COHEN",
"authorized_official_first_name": "MARC",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "801-743-2800",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5386155",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NPI",
"identifier": "1841279155",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.