Provider Demographics
NPI:1235136987
Name:DIABETES CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:DIABETES CORPORATION OF AMERICA
Other - Org Name:DCA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-832-7232
Mailing Address - Street 1:233 BEDFORD WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5527
Mailing Address - Country:US
Mailing Address - Phone:615-832-7232
Mailing Address - Fax:615-331-6673
Practice Address - Street 1:233 BEDFORD WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5527
Practice Address - Country:US
Practice Address - Phone:615-832-7232
Practice Address - Fax:615-331-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3440333600000X, 333600000X
TN0000000792332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54009865Medicaid
KY90007071Medicaid
TN1454281Medicaid
TN4434964OtherNCPDP NUMBER
TN1454281Medicaid