Organization
WESTERN DIABETIC SUPPLY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN PLUMB (COO)
(801) 727-0080
Entity
Organization
Contact information
Practice address
3293 HARRISON BLVD, SUITE 210, OGDEN, UT 84403-1226
(877) 937-8342
(866) 808-3418
Mailing address
3293 HARRISON BLVD, SUITE 210, OGDEN, UT 84403-1226
(877) 937-8342
(866) 808-3418
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1005116
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10051160000001
BLUECROSS/BLUE SHIELD
UT
01
—
1028334
UNITED HEALTH CARE
UT
Enumeration date
04/28/2006
Last updated
03/23/2012
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