Provider Demographics
NPI:1982792586
Name:DSF OF THE VALLEY, INC
Entity Type:Organization
Organization Name:DSF OF THE VALLEY, INC
Other - Org Name:DIRECT DIABETES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:LINK
Authorized Official - Last Name:GULDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-990-8552
Mailing Address - Street 1:PO BOX 4907
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-4907
Mailing Address - Country:US
Mailing Address - Phone:480-990-8552
Mailing Address - Fax:
Practice Address - Street 1:10643 N FRANK LLOYD WRIGHT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2699
Practice Address - Country:US
Practice Address - Phone:480-990-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20053502332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0984340001Medicare ID - Type Unspecified