Organization Active NPI

Home Diabetic Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • San Antonio, TX
National Provider Identifier
1992840151
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HOME DIABETIC SUPPLIES LLC
Practice address
1716 S San Marcos
Suite 25
San Antonio, TX 78207-7094
Phone
(210) 223-9981
Fax
(210) 223-9128
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Authorized official

Name
Armando Natividad
Title
Member
Phone
(210) 223-9128

Specialties & licenses 1

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

Addresses

Primary practice location

1716 S San Marcos
Suite 25
San Antonio, TX 78207-7094

Mailing address

1716 S San Marcos
Suite 25
San Antonio, TX 78207-7094
Phone (210) 223-9981

Other identifiers 2

IdentifierTypeStateIssuer
192417702MedicaidTX
192417701MedicaidTX

National Provider Directory

National Provider Directory

Locations

1716 S San Marcos
Ste 25
San Antonio, TX 78207
Phone (210) 223-9981

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1992840151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 S SAN MARCOS",
            "address_2": "SUITE 25",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077094",
            "telephone_number": "210-223-9981",
            "fax_number": "210-223-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 S SAN MARCOS",
            "address_2": "SUITE 25",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077094",
            "telephone_number": "210-223-9981",
            "fax_number": "210-223-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME DIABETIC SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "NATIVIDAD",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "210-223-9128"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192417702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192417701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.