Diabetic Specialties & Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

770 Issued in TN

Legal business name

DIABETIC SPECIALTIES & SUPPLY

Practice address

385 S Main St
Memphis, TN 38103-4238

Phone

(901) 577-0016

Fax

(901) 578-5108

NPI assigned

Aug 25, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Laura D Taylor

Title

Owner

Phone

(901) 577-0016

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700879632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3242",
            "address_2": "385 SOUTH MAIN",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381730242",
            "telephone_number": "901-577-0016",
            "fax_number": "901-578-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S MAIN ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034238",
            "telephone_number": "901-577-0016",
            "fax_number": "901-578-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SPECIALTIES & SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-577-0016",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4582329",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Rose Di Virgilio
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• Diagnostic Imaging PC
• Alicia Janel Diallo, MS, CCC-SLP
• Dialysis Management Corp
• Dialysis Newco LLC
• Dialysis Newco, Inc.

• All providers in Memphis, TN
• Durable Medical Equipment & Medical Supplies in Tennessee

• 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.