Provider Demographics
NPI:1093397374
Name:DIABETIC SOULTIONS
Entity Type:Organization
Organization Name:DIABETIC SOULTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-833-2000
Mailing Address - Street 1:12600 E 40 HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5909
Mailing Address - Country:US
Mailing Address - Phone:816-876-4495
Mailing Address - Fax:816-833-2001
Practice Address - Street 1:12600 E 40 HWY STE 301
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5909
Practice Address - Country:US
Practice Address - Phone:816-876-4495
Practice Address - Fax:816-833-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies