Provider Demographics
NPI:1710916481
Name:AMERICAN MEDICAL & DIABETIC SUPPLIES, LLC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL & DIABETIC SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SHOWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-643-2800
Mailing Address - Street 1:3050 VALLEY AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2668
Mailing Address - Country:US
Mailing Address - Phone:866-643-2800
Mailing Address - Fax:800-753-5266
Practice Address - Street 1:3050 VALLEY AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2668
Practice Address - Country:US
Practice Address - Phone:866-643-2800
Practice Address - Fax:800-753-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
464468OtherBCBS
5284130001Medicare NSC