Organization
DIABETIC SUPPLY SOURCE, INC DBA DSS MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SHUFORD V SHUFORD SR. (PRESIDENT)
(803) 799-3505
Entity
Organization
Contact information
Practice address
2805 MILLWOOD AVE, COLUMBIA, SC 29205-1298
(803) 799-3505
(803) 779-3505
Mailing address
2805 MILLWOOD AVENUE, COLUMBIA, SC 29205
(803) 799-3505
(803) 779-3505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
002745
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DM0745
—
SC
Enumeration date
06/28/2006
Last updated
01/27/2012
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