Diabetic Supply Source, Inc

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

50-008619 Issued in SC

Legal business name

DIABETIC SUPPLY SOURCE, INC

Practice address

2805 Millwood Ave
Columbia, SC 29205-1298

Phone

(803) 799-3505

Fax

(803) 256-1083

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Shuford

Title

Owner

Phone

(803) 799-3505

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710022322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25534",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292245534",
            "telephone_number": "803-799-3505",
            "fax_number": "803-256-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 MILLWOOD AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051298",
            "telephone_number": "803-799-3505",
            "fax_number": "803-256-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SUPPLY SOURCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUFORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-799-3505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "SC",
            "license": "50-008619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4226292",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786194",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT NUMBER",
            "identifier": "50-008619",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glynnis Christine Dexter
• Plechette Anne Dey-Foy, APRN
• Robert E Deysach
• Dhec Hemophilia-Cshcn Program
• Nadia Dhuey, APRN
• Diabetic Supply Source, Inc Dba DSS Medical
• Diagnostic & Comprehensive Foot Care
• Diagnostic and Interventional Cardiology Associates, P.a
• Burke Hood Dial, M.D.
• Samantha Jasmine Dial, DDS

• Mail Order Pharmacy in Columbia, SC
• Providers in Columbia, SC by specialty
• Mail Order Pharmacy in South 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.