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Organization
DIABETES SUPPLY CENTER OF THE MIDLANDS LLC
Active
Organization
DIABETES SUPPLY CENTER OF THE MIDLANDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CHIEF COMPLIANCE OFFICER)
(484) 246-9499
Entity
Organization
Contact information
Practice address
10304 CROWN POINT AVE, OMAHA, NE 68134-1060
(402) 399-8444
(402) 614-3850
Mailing address
10304 CROWN POINT AVE, OMAHA, NE 68134-1060
(402) 399-8444
(402) 614-3850
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0987867
—
IA
01
—
09931
BCBS
NE
01
—
2815035
NABP
NE
Enumeration date
08/03/2006
Last updated
07/03/2024
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