Provider Demographics
NPI:1598094104
Name:EDWARDS HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:EDWARDS HEALTH CARE SERVICES, INC.
Other - Org Name:DIABETES CARE & EDUCATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:330-342-9555
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-0309
Mailing Address - Country:US
Mailing Address - Phone:330-342-9555
Mailing Address - Fax:330-342-9559
Practice Address - Street 1:150 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 126 B31
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4505
Practice Address - Country:US
Practice Address - Phone:864-288-6363
Practice Address - Fax:864-288-6385
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDWARDS HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-10
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3273Medicaid
0851010003Medicare NSC