NPIMap

Organization Active NPI

Diabetic Health Supply, Inc

  • Durable Medical Equipment & Medical Supplies
  • Fort Myers, FL
National Provider Identifier
1750385035
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
5282130001 Issued in FL
Legal business name
DIABETIC HEALTH SUPPLY, INC
Practice address
9031 Pittsburgh Blvd
Fort Myers, FL 33967-7206
Phone
(239) 437-4004
Fax
(239) 437-4008
NPI assigned
Jun 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lynn C Redavid
Title
President/Customer Service Manager
Phone
(239) 437-4004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 5282130001 FL Primary

Addresses

Primary practice location

9031 Pittsburgh Blvd
Fort Myers, FL 33967-7206

Mailing address

9031 Pittsburgh Blvd
Fort Myers, FL 33967-7206
Phone (239) 437-4004

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750385035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 PITTSBURGH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339677206",
            "telephone_number": "239-437-4004",
            "fax_number": "239-437-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 PITTSBURGH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339677206",
            "telephone_number": "239-437-4004",
            "fax_number": "239-437-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC HEALTH SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REDAVID",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/CUSTOMER SERVICE MANAGER",
        "authorized_official_telephone_number": "239-437-4004"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "5282130001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • 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.