Provider Demographics
NPI:1073869038
Name:DIABETESKARE LLC
Entity Type:Organization
Organization Name:DIABETESKARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOSTERMAN-SABEL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDE
Authorized Official - Phone:765-463-3333
Mailing Address - Street 1:1305 CUMBERLAND AVE
Mailing Address - Street 2:SUITE 108B
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1310
Mailing Address - Country:US
Mailing Address - Phone:765-463-3333
Mailing Address - Fax:765-463-3334
Practice Address - Street 1:1305 CUMBERLAND AVE
Practice Address - Street 2:SUITE 108B
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1310
Practice Address - Country:US
Practice Address - Phone:765-463-3333
Practice Address - Fax:765-463-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty