Diabetes Store Incorporated

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIABETES STORE INCORPORATED

Practice address

1760 Moriah Woods Blvd
Suite 2
Memphis, TN 38117-7128

Phone

(901) 312-3150

Fax

(800) 208-0863

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Toshio Serizawa

Title

President

Phone

(612) 709-4079

Specialties & licenses 2

Addresses

Other names 1

• Diabetes Store, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Tax ID family

Diabetes Store Incorporated4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Diabetes Store, Incorporated

  • Mail Order Pharmacy
  • Memphis, TN
  • NPI 1285191478
  NPD tax ID
• Diabetes Store, Incorporated

  • Pharmacy
  • Memphis, TN
  • NPI 1467508598
  NPD tax ID
• Diabetes Store, Incorporated

  • Prosthetic/Orthotic Supplier
  • Memphis, TN
  • NPI 1740875400
  NPD tax ID

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1972529451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 MORIAH WOODS BLVD",
            "address_2": "SUITE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177128",
            "telephone_number": "901-312-3150",
            "fax_number": "901-312-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 MORIAH WOODS BLVD",
            "address_2": "SUITE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177128",
            "telephone_number": "901-312-3150",
            "fax_number": "800-208-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES STORE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "SERIZAWA",
        "authorized_official_first_name": "TOSHIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-709-4079"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes Store, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anita Dey, MD
• Ramasubbareddy Dhanireddy, MD
• Thirumalaivasan Dhasakeerthi, M.B.B.S
• DHP of Tennessee PC
• Shannon Rose Di Virgilio
• Diabetes Store, Incorporated
• Diabetes Store, Incorporated
• Diabetes Store, Incorporated
• Diabetic Specialties & Supply
• Diagnostic Imaging PC

• Durable Medical Equipment & Medical Supplies in Memphis, TN
• Providers in Memphis, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.