| NPI | 1003101296 |
|---|---|
| Former Legal Business Name | JADE DIABETIC GROUP |
| Entity Type | Organization |
| Authorized Contact | DALE GREYSLAK Managing Member 321-267-7576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2013-08-23 |