Organization
DIABETES SELF-MANAGEMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER C. NOVEMBER II (VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
420 W PINHOOK RD, SUITE A, LAFAYETTE, LA 70503-2131
(337) 232-1717
(337) 232-1767
Mailing address
P.O. BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C8672
BLUE CROSS BLUE SHIELD OF
LA
Enumeration date
07/09/2006
Last updated
11/06/2009
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