NPIMap

Organization Active NPI

Aediabetic3

  • Durable Medical Equipment & Medical Supplies
  • Lexington, SC
National Provider Identifier
1912134248
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AEDIABETIC3
Practice address
300 Palmetto Park Blvd Apt 309
Lexington, SC 29072-7877
Phone
(803) 520-8117
Fax
(803) 520-8117
NPI assigned
Jun 12, 2009
Last updated
Jun 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Authorized official

Name
Mrs. Alice Denise Etheredge
Title
Diabetic Consultant
Phone
(803) 520-8117

Specialties & licenses 1

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

Addresses

Primary practice location

300 Palmetto Park Blvd Apt 309
Lexington, SC 29072-7877

Mailing address

300 Palmetto Park Blvd Apt 309
Lexington, SC 29072-7877
Phone (803) 520-8117

National Provider Directory

National Provider Directory
Tax ID family
Aediabetic32 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1912134248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PALMETTO PARK BLVD APT 309",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727877",
            "telephone_number": "803-520-8117",
            "fax_number": "803-520-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PALMETTO PARK BLVD APT 309",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727877",
            "telephone_number": "803-520-8117",
            "fax_number": "803-520-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEDIABETIC3",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "ETHEREDGE",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DIABETIC CONSULTANT",
        "authorized_official_telephone_number": "803-520-8117",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.