Provider Demographics
NPI:1578960258
Name:JUST DIABETIC SUPPLIES, LLC
Entity Type:Organization
Organization Name:JUST DIABETIC SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-616-6111
Mailing Address - Street 1:345 N RIVERVIEW ST
Mailing Address - Street 2:STE 600
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 N RIVERVIEW ST
Practice Address - Street 2:STE 600
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4200
Practice Address - Country:US
Practice Address - Phone:316-616-6111
Practice Address - Fax:316-616-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies