Organization
DIABETICSUPPLIESOFTAMINC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRILL ANN MCGEE (PRESIDENT)
(704) 394-8301
Entity
Organization
Contact information
Practice address
3316 MIRANDA RD, CHARLOTTE, NC 28216-9608
(704) 394-8301
(704) 394-8302
Mailing address
3316 MIRANDA RD, CHARLOTTE, NC 28216-9608
(704) 394-8301
(704) 394-8302
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00543
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04269
BLUE CROSS BLUE SHIELD NC
NC
05
—
7702019
—
NC
Enumeration date
03/08/2006
Last updated
08/22/2020
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