Provider Demographics
NPI:1942711890
Name:DIABETES COMMUNITY CARE TEAM
Entity Type:Organization
Organization Name:DIABETES COMMUNITY CARE TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWSNUP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CDE, AAHIVP
Authorized Official - Phone:541-257-8553
Mailing Address - Street 1:207 E 5TH AVE STE 223
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2762
Mailing Address - Country:US
Mailing Address - Phone:855-211-3228
Mailing Address - Fax:855-565-3626
Practice Address - Street 1:207 E 5TH AVE STE 223
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2762
Practice Address - Country:US
Practice Address - Phone:855-211-3228
Practice Address - Fax:855-565-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X, 251V00000X, 261QC1500X, 332B00000X, 3336C0003X, 3336S0011X
ORRP-0003347333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
No251V00000XAgenciesVoluntary or Charitable
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy