Organization
DIABETES STORE, INCORPORATED
Active
Other names
Diabetes Store, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG BROSSEAU (SECRETARY)
(952) 646-3255
Entity
Organization
Contact information
Practice address
777 DELTONA BLVD STE 4, DELTONA, FL 32725-7174
(901) 312-3150
(800) 208-0863
Mailing address
1760 MORIAH WOODS BLVD STE 2, MEMPHIS, TN 38117-7128
(901) 312-3150
(800) 208-0863
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4425570004
MEDICARE
FL
Enumeration date
11/11/2019
Last updated
11/11/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up