Provider Demographics
NPI:1235279068
Name:NATIONAL DIABETIC SUPPLIES GROUP, INC
Entity Type:Organization
Organization Name:NATIONAL DIABETIC SUPPLIES GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-249-2187
Mailing Address - Street 1:5501 W WATERS AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1229
Mailing Address - Country:US
Mailing Address - Phone:813-249-2187
Mailing Address - Fax:813-887-4148
Practice Address - Street 1:5501 W WATERS AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1229
Practice Address - Country:US
Practice Address - Phone:813-249-2187
Practice Address - Fax:813-887-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1072860001Medicare ID - Type Unspecified