Western Diabetic Supply Corporation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1005116 Issued in UT

Legal business name

WESTERN DIABETIC SUPPLY CORPORATION

Practice address

3293 Harrison Blvd
Suite 210
Ogden, UT 84403-1226

Phone

(877) 937-8342

Fax

(866) 808-3418

NPI assigned

Apr 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Plumb

Title

Coo

Phone

(801) 727-0080

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1427015718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3293 HARRISON BLVD",
            "address_2": "SUITE 210",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031226",
            "telephone_number": "877-937-8342",
            "fax_number": "866-808-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3293 HARRISON BLVD",
            "address_2": "SUITE 210",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031226",
            "telephone_number": "877-937-8342",
            "fax_number": "866-808-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DIABETIC SUPPLY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "PLUMB",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "801-727-0080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "1005116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "10051160000001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1028334",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan West, DPT
• Renee R West, MD
• Westbroek Family Medicine PLLC
• Ryan Westbroek, FNP
• Chad Westenskow
• Jesse R Western
• Patricia Weyman
• Shannon Cherie Whaley
• Adam Wheatley, BSN
• Brett Wheeler

• Durable Medical Equipment & Medical Supplies in Ogden, UT
• Providers in Ogden, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.