# CGM DIABETIC SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821610122
- **Authorized official:** WILLIAM ROBERT BAYLIS (AUTHORIZED MEMBER)
- **Authorized official phone:** (561) 570-5915

## Contact information

- **Practice address:** 4400 N FEDERAL HWY STE 210-49, BOCA RATON, FL 33431-5187
- **Practice address phone:** (561) 570-5915
- **Mailing address:** 1271 SW 13TH DR, BOCA RATON, FL 33486-5364
- **Mailing address phone:** (561) 299-6893

## Taxonomy

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

## Other

- **Enumeration date:** 05/11/2020
- **Last updated:** 05/11/2020