# COUNTRY SOUTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DIABETIC SUPPLY OF AMERICA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477556389
- **Authorized official:** KATHERINE ELIZABETH FISCINA (PRESIDENT)
- **Authorized official phone:** (239) 514-1156

## Contact information

- **Practice address:** 5567 TAYLOR RD, STE 8, NAPLES, FL 34109-1880
- **Practice address phone:** (239) 514-1156
- **Practice address fax:** (239) 514-1159
- **Mailing address:** PO BOX 110189, NAPLES, FL 34108-0104
- **Mailing address phone:** (239) 514-1156
- **Mailing address fax:** (239) 514-1159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 943257 | FL | Yes |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 09/15/2009