Provider Demographics
NPI:1093852204
Name:EZ DIABETES MANAGEMENT
Entity Type:Organization
Organization Name:EZ DIABETES MANAGEMENT
Other - Org Name:EXPRESS MEDICAL SUPPLY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FRANCISKA
Authorized Official - Middle Name:TEREZIA
Authorized Official - Last Name:PALFI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-630-6959
Mailing Address - Street 1:11911 US HIGHWAY 1
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2827
Mailing Address - Country:US
Mailing Address - Phone:561-630-6959
Mailing Address - Fax:561-630-9518
Practice Address - Street 1:11911 US HIGHWAY 1
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2827
Practice Address - Country:US
Practice Address - Phone:561-630-6959
Practice Address - Fax:561-630-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1097690001Medicare NSC