Organization
COUNTRY SOUTH INC
Active
Other names
DIABETIC SUPPLY OF AMERICA
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE ELIZABETH FISCINA (PRESIDENT)
(239) 514-1156
Entity
Organization
Contact information
Practice address
5567 TAYLOR RD, STE 8, NAPLES, FL 34109-1880
(239) 514-1156
(239) 514-1159
Mailing address
PO BOX 110189, NAPLES, FL 34108-0104
(239) 514-1156
(239) 514-1159
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
943257
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
951568200
—
FL
Enumeration date
05/24/2005
Last updated
09/15/2009
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