Organization
DIABETIC SUPPLIES AND MORE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS DIANE JORDAN (PRESIDENT)
(702) 649-5600
Entity
Organization
Contact information
Practice address
6230 MCLEOD DR, # 140, LAS VEGAS, NV 89120-4049
(702) 649-5600
(702) 736-2199
Mailing address
6230 MCLEOD DR, # 140, LAS VEGAS, NV 89120-4049
(702) 649-5600
(702) 736-2199
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MP00320
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128099
—
CT
05
—
100505201
—
NV
Enumeration date
05/18/2006
Last updated
04/01/2009
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