Organization
DIABETES EXPRESS SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDRICK EBANKS (OWNER)
(225) 925-2232
Entity
Organization
Contact information
Practice address
4560 NORTH BLVD, SUITE 102, BATON ROUGE, LA 70806-4043
(225) 925-2232
(225) 926-4713
Mailing address
4560 NORTH BLVD, SUITE 102, BATON ROUGE, LA 70806-4043
(225) 925-2232
(225) 926-4713
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478750
—
LA
Enumeration date
02/12/2007
Last updated
10/16/2008
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