Provider Demographics
NPI:1942374293
Name:DIABETIC SUPPLY FOUNDATION OF DELRAY INC
Entity Type:Organization
Organization Name:DIABETIC SUPPLY FOUNDATION OF DELRAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:STEIN
Authorized Official - Last Name:RAITHEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-367-4658
Mailing Address - Street 1:7491 N FEDERAL HWY
Mailing Address - Street 2:C5 155
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1625
Mailing Address - Country:US
Mailing Address - Phone:561-367-4658
Mailing Address - Fax:561-367-9913
Practice Address - Street 1:1261 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-5307
Practice Address - Country:US
Practice Address - Phone:561-367-4658
Practice Address - Fax:561-367-9913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR8144OtherBLUE CROSS BLUE SHIELD OF
FLR8144OtherBLUE CROSS BLUE SHIELD OF