Diabetes Specialty Center LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

4781762-0160 Issued in UT

Legal business name

DIABETES SPECIALTY CENTER LLC

Practice address

3793 South State Street
Salt Lake City, UT 84115-4828

Phone

(801) 268-9699

Fax

(801) 268-9929

NPI assigned

Jan 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Kim E Doman

Title

Controller

Phone

(801) 263-5442

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Byram Healthcare Centers, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Downers Grove, IL
  • NPI 1053366740

  Member Of

  NPD member

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1841279155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3793 SOUTH STATE STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84115",
            "telephone_number": "801-268-9699",
            "fax_number": "801-268-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3793 SOUTH STATE STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154828",
            "telephone_number": "801-268-9699",
            "fax_number": "801-268-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES SPECIALTY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "DOMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "801-263-5442",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "4781762-0160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184127915501",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Marie Di Fulvio, C.S.A.C.
• Jocelyn Di Nolfi, M.D.
• Diabetes RN LLC
• Diabetes Specialty Center
• Diabetes Specialty Center LLC
• Diabetes Specialty Center, LLC
• Diabetic Treatment Centers of America
• Nicholas Diachun
• Diagnopy, LLC
• Diana Maria Diakow

• Durable Medical Equipment & Medical Supplies in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.