Diabetic Life Supply, LLC.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIABETIC LIFE SUPPLY, LLC.

Practice address

4270 S Decatur Blvd
Ste. B1-B
Las Vegas, NV 89103-6802

Phone

(702) 880-9500

Fax

(702) 880-9507

NPI assigned

Sep 14, 2007

Last updated

Jun 24, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Edward Miller Jr.

Title

Ceo

Phone

(702) 880-9500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1629264429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD",
            "address_2": "STE. B1-B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-880-9500",
            "fax_number": "702-880-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD",
            "address_2": "STE. B1-B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-880-9500",
            "fax_number": "702-880-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC LIFE SUPPLY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-880-9500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100513194",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Di Pietro
• Nelida Susana Di Prospero de Barrientos
• Diabetes Health Centers Inc
• Diabetes Management Consultants LLC
• Diabetic Life Academy, LLC
• Diabetic Relief Network
• Diabetic Supplies and More, Inc
• Fatoumata Diafoune
• Diagnostic Center of Medicine
• Diagnostic Center of Medicine (Allen) LLP (Diagnostic Center of Medicine)

• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.