Provider Demographics
NPI:1588644736
Name:DIABETES PLUS, INC.
Entity Type:Organization
Organization Name:DIABETES PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:GIELNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-285-9330
Mailing Address - Street 1:32875 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-7367
Mailing Address - Country:US
Mailing Address - Phone:586-285-9330
Mailing Address - Fax:586-285-9370
Practice Address - Street 1:32875 HAYES RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-7367
Practice Address - Country:US
Practice Address - Phone:586-285-9330
Practice Address - Fax:586-285-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-21
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101795Medicaid
MI5101795Medicaid