Diabetic and Medial Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIABETIC AND MEDIAL SUPPLY

Practice address

1418 S Main St
Greenville, MS 38701-7026

Phone

(662) 332-8848

NPI assigned

May 22, 2007

Last updated

Apr 20, 2008By 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

Mrs. Kristie Everitt

Title

Owner

Phone

(662) 332-8848

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1821207267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 S MAIN ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387017026",
            "telephone_number": "662-332-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 S MAIN ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387017026",
            "telephone_number": "662-332-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC AND MEDIAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "EVERITT",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-332-8848",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07634577",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Greenville, MS
• Providers in Greenville, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.