Diabetic Support Services, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00986 Issued in NC

Legal business name

DIABETIC SUPPORT SERVICES, INC.

Practice address

19837 S Main St
Cornelius, NC 28031-8515

Phone

(704) 892-2800

Fax

(704) 892-2804

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Max L. Ford, CFO

Title

Owner

Phone

(704) 892-2800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497780969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19837 S MAIN ST",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318515",
            "telephone_number": "704-892-2800",
            "fax_number": "704-892-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19837 S MAIN ST",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318515",
            "telephone_number": "704-892-2800",
            "fax_number": "704-892-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-892-2800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "00986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madalyn Marie Derrick, LCSW
• Suresh Jayantha Desilva, MD
• Stacey E Devine, M.D.
• Diabetic Special Care
• Diabetic Supply Institute Inc
• Brittany Nicole Diaconu
• Teresa Dillard, LMFT
• Christina Dishmond, NP
• Divine Haven Inc
• Alexandra Michele Dixon, PA

• Durable Medical Equipment & Medical Supplies in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• 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.