Diabetic Supply Foundation of 94 Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIABETIC SUPPLY FOUNDATION OF 94 INC

Practice address

124A Huntersville Concord Rd
Huntersville, NC 28078-6215

Phone

(704) 875-0733

Fax

(704) 948-9704

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sonya K McGee

Title

Owner

Phone

(704) 875-0733

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Diabetic Supply of 94 Inc. Other name

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1992772081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 976",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280700976",
            "telephone_number": "704-875-0733",
            "fax_number": "704-948-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124A HUNTERSVILLE CONCORD RD",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786215",
            "telephone_number": "704-875-0733",
            "fax_number": "704-948-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SUPPLY FOUNDATION OF 94 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-875-0733",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77701560",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM0661",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBLUE SHIELD PROVIDER ID",
            "identifier": "0463E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009113126",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Supply of 94 Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ruairi Laurence Devereux, BCBA
• Jonathan Devore
• Jennifer Ann Dewitt, LICSW
• Rajat Dhungana, M.D.
• Diabetes Supply of Charlotte
• Diana'S Home Care, Inc.
• Diana'S Homecare, Inc
• Alyssa Jarvis Dias, FNP
• Tanya L Diaz
• Erin S. Dice, PA C

• Durable Medical Equipment & Medical Supplies in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.