Country South Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

943257 Issued in FL

Legal business name

COUNTRY SOUTH INC

Doing business as

Diabetic Supply of America

Practice address

5567 Taylor Rd
Ste 8
Naples, FL 34109-1880

Phone

(239) 514-1156

Fax

(239) 514-1159

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Katherine Elizabeth Fiscina

Title

President

Phone

(239) 514-1156

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DIABETIC SUPPLY OF AMERICA Doing business as

Locations

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1477556389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110189",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341080104",
            "telephone_number": "239-514-1156",
            "fax_number": "239-514-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5567 TAYLOR RD",
            "address_2": "STE 8",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341091880",
            "telephone_number": "239-514-1156",
            "fax_number": "239-514-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY SOUTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "FISCINA",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-514-1156"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "943257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951568200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIABETIC SUPPLY OF AMERICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Naples, FL
• Providers in Naples, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.