Active NPI
Ez Diabetic Supplies, Inc.
- Durable Medical Equipment & Medical Supplies
- West Bath, ME
National Provider Identifier
1689677023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- EZ DIABETIC SUPPLIES, INC.
- Practice address
- 61 State Rd
West Bath, ME 04530-6301 - Phone
- (207) 386-1080
- Fax
- (207) 386-1088
- NPI assigned
- May 31, 2005
- Last updated
- Apr 25, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Elliot M. Zimmerman
- Title
- President
- Phone
- (207) 386-1080
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
61 State Rd
West Bath, ME 04530-6301
Mailing address
61 State Rd
West Bath, ME 04530-6301
Phone (207) 386-1080
Other identifiers 23
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06559353 | Medicaid | MS | |
| 009975265 | Medicaid | AL | |
| 155450000 | Medicaid | ME | |
| 1689677023 | Medicaid | CA | |
| 30762818 | Medicaid | NH | |
| 3810004618 | Medicaid | WV | |
| 7783934 | Medicaid | PA | |
| ZERO3161800 | Medicaid | NY | |
| 010369258 | Medicaid | VA | |
| 1689677023 | Medicaid | MI | |
| 2428733 | Medicaid | OH | |
| 047029 | Other | ME | ANTHEM BCBS |
| 4582522 | Medicaid | TN | |
| 90013939 | Medicaid | KY | |
| 100249992-00 | Medicaid | NE | |
| 1017916 | Medicaid | VT | |
| 159235741 | Medicaid | AR | |
| DM1153 | Medicaid | SC | |
| 1689677023 | Medicaid | MN | |
| 1344494 | Medicaid | LA | |
| 1689677023 | Medicaid | UT | |
| 200916420 A | Medicaid | IN | |
| ZERO43692703001 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
61 State Rd
West Bath, ME 04530
Phone (207) 386-1080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1335312000000",
"number": "1689677023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 STATE RD",
"city": "WEST BATH",
"state": "ME",
"postal_code": "045306301",
"telephone_number": "207-386-1080",
"fax_number": "207-386-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 STATE RD",
"city": "WEST BATH",
"state": "ME",
"postal_code": "045306301",
"telephone_number": "207-386-1080",
"fax_number": "207-386-1088"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EZ DIABETIC SUPPLIES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-31",
"last_updated": "2012-04-25",
"status": "A",
"authorized_official_last_name": "ZIMMERMAN",
"authorized_official_first_name": "ELLIOT",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "207-386-1080",
"authorized_official_name_prefix": "Mr."
},
"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": "06559353",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009975265",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "155450000",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689677023",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30762818",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810004618",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7783934",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZERO3161800",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010369258",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689677023",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2428733",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "047029",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4582522",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90013939",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100249992-00",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017916",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159235741",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DM1153",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689677023",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1344494",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689677023",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200916420 A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZERO43692703001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Bath, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.