Organization
DIABETIC SUPPLIES OF AMERICA, INC
Active
Other names
DSA Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WARNER D HAWLEY (PRESIDENT)
(800) 555-2561
Entity
Organization
Contact information
Practice address
802 OLD DIXIE HWY, SUITE 3, LAKE PARK, FL 33403-2361
(800) 555-2561
(561) 840-1042
Mailing address
802 OLD DIXIE HWY, SUITE 3, LAKE PARK, FL 33403-2361
(800) 555-2561
(561) 840-1042
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06300700
—
FL
01
—
R8243
BCBS OF FLORIDA
FL
Enumeration date
02/06/2007
Last updated
07/21/2022
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