Provider Demographics
NPI:1255458907
Name:DIABETES CARE & EDUCATION, INC
Entity type:Organization
Organization Name:DIABETES CARE & EDUCATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-903-5000
Mailing Address - Street 1:2700 STANLEY GAULT PARKWAY
Mailing Address - Street 2:SUITE 129
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5133
Mailing Address - Country:US
Mailing Address - Phone:502-412-3253
Mailing Address - Fax:502-412-3253
Practice Address - Street 1:2700 STANLEY GAULT PARKWAY
Practice Address - Street 2:SUITE 129
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5133
Practice Address - Country:US
Practice Address - Phone:502-412-3253
Practice Address - Fax:502-412-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9366401Medicare ID - Type Unspecified