Organization Active NPI

Quality Diabetes Supplies, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Birmingham, AL
National Provider Identifier
1407966153
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
485 Issued in AL
Legal business name
QUALITY DIABETES SUPPLIES, INC.
Practice address
438 Carr Ave
Suite 1
Birmingham, AL 35209-6147
Phone
(205) 942-0114
Fax
(295) 942-6472
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edward Mark Fredrickson
Title
President
Phone
(205) 942-0114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 485 AL Primary

Addresses

Primary practice location

438 Carr Ave
Suite 1
Birmingham, AL 35209-6147

Mailing address

438 Carr Ave
Suite 1
Birmingham, AL 35209-6147
Phone (205) 942-0114

Other identifiers 1

IdentifierTypeStateIssuer
7703878MedicaidNC

National Provider Directory

National Provider Directory

Locations

438 Carr Ave
Ste 1
Birmingham, AL 35209
Phone (205) 942-0114

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407966153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 CARR AVE",
            "address_2": "SUITE 1",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096147",
            "telephone_number": "205-942-0114",
            "fax_number": "295-942-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 CARR AVE",
            "address_2": "SUITE 1",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096147",
            "telephone_number": "205-942-0114",
            "fax_number": "295-942-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY DIABETES SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREDRICKSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-942-0114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703878",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.