| NPI | 1316124779 |
|---|---|
| Former Legal Business Name | DIABETIC SUPPLY PROVIDERS |
| Entity Type | Organization |
| Authorized Contact | EMILY STACKS Owner 803-283-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2011-11-15 |