Provider Demographics
NPI:1023045564
Name:CYNTHIA K RIGGS D.B.A. WESTERN DIABETIC DELIVERY SERVICE
Entity Type:Organization
Organization Name:CYNTHIA K RIGGS D.B.A. WESTERN DIABETIC DELIVERY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-244-8421
Mailing Address - Street 1:217 NAVIDAD ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-2105
Mailing Address - Country:US
Mailing Address - Phone:979-244-8421
Mailing Address - Fax:979-245-2132
Practice Address - Street 1:217 NAVIDAD ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-2105
Practice Address - Country:US
Practice Address - Phone:979-244-8421
Practice Address - Fax:979-245-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087004332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90011578Medicaid
OR275581Medicaid
UTIDX42335OtherHEALTHY U MEDICAID
NM90136811Medicaid
TX141809701Medicaid
SCDM1189Medicaid
PA101580178 0001Medicaid
AR159677716Medicaid
LA1623334Medicaid
WA9056912Medicaid
OK100816220 AMedicaid
IDXWHJ2326Medicaid
MS01671724Medicaid
AZ554883Medicaid
WA9056912Medicaid
UT=========002Medicaid