Provider Demographics
NPI:1023062361
Name:G E DIABETIC SUUPLY, INC
Entity type:Organization
Organization Name:G E DIABETIC SUUPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OHAYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-210-5625
Mailing Address - Street 1:810 SE 8TH AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-5623
Mailing Address - Country:US
Mailing Address - Phone:561-210-5625
Mailing Address - Fax:561-210-7452
Practice Address - Street 1:810 SE 8TH AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5623
Practice Address - Country:US
Practice Address - Phone:561-210-5625
Practice Address - Fax:561-210-7452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5503290001Medicare ID - Type Unspecified