| NPI | 1104800440 |
|---|---|
| Doing Business As | THE DIABETIC SHOPPE |
| Entity Type | Organization |
| Authorized Contact | ROBERT SALMON Pharmacist 662-647-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 06473/11.1) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 1022) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT 8226997-1714) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 056014) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID DME18182) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR NPC-0003778) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NV MP00957) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ P013728) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2019-07-11 |