A1 Diabetes & Medical Supply, Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Eustis, FL

NPI 1366436107 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1366436107
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
A1 DIABETES & MEDICAL SUPPLY, INC.
Practice address
636 S Bay St
Eustis, FL 32726-4860
Phone
(352) 589-1177
Fax
(352) 589-0629
NPI assigned
Sep 8, 2005
Organization subpart
No

Authorized official

Name
Mr. Michael E Hennessy
Title
President
Phone
(321) 255-9800

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X FL Yes

Addresses

Primary practice location

636 S Bay St
Eustis, FL 32726-4860

Mailing address

2092 Sarno Rd
Melbourne, FL 32935-3077
Phone (321) 255-9800

Other identifiers

IdentifierTypeStateIssuer
R6834OtherFLBCBS IDENTIFIER

Other names

  • Lake Diabetes & Medical Supply, Inc. Former legal business name

Other providers in Eustis, FL

All providers in Eustis, FL · Durable Medical Equipment & Medical Supplies in Florida

Sources for this page

Verify at the official NPI Registry.