Provider Demographics
NPI:1831292622
Name:NIPRO DIABETES SYSTEMS
Entity Type:Organization
Organization Name:NIPRO DIABETES SYSTEMS
Other - Org Name:NIPRO HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-435-5665
Mailing Address - Street 1:3361 ENTERPRISE WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3932
Mailing Address - Country:US
Mailing Address - Phone:954-435-5665
Mailing Address - Fax:954-241-0831
Practice Address - Street 1:3361 ENTERPRISE WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3932
Practice Address - Country:US
Practice Address - Phone:954-435-5665
Practice Address - Fax:954-241-0831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL07 547332B00000X
FLPH 212683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1011965OtherNCPDP
FL1011965OtherNCPDP