Diabetic Services & Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIABETIC SERVICES & SUPPLIES INC

Practice address

109 Carden PL
Saint Johns, FL 32259-7217

Phone

(904) 230-7667

Fax

(866) 435-9440

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Blaker, C-PED

Title

President

Phone

(904) 230-7667

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1982765095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CARDEN PL",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597217",
            "telephone_number": "904-230-7667",
            "fax_number": "866-435-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CARDEN PL",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597217",
            "telephone_number": "904-230-7667",
            "fax_number": "866-435-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SERVICES & SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "BLAKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-230-7667",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C-PED"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Ryan Deboer, DO
• Theressa Demostene
• Dennis Stone, M.D., P.a.
• Developing Growth Again, LLC
• Diabetic Medical Concepts, Inc.
• Xavier Emilio Acosta Diaz-Hernandez, MD
• Jamie Dingianni, I.T.D.S.
• Zachary Richard Dionise
• Karen Dixon Hathcock, LMHC
• Yelena R Dorrian, PHARMD

• Durable Medical Equipment & Medical Supplies in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.