Organization
DIABETES CORNER STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON CASE (PARTNER)
(845) 277-1810
Entity
Organization
Contact information
Practice address
310 GUINEA RD, BREWSTER, NY 10509-2651
(845) 277-1810
(845) 277-2851
Mailing address
310 GUINEA RD, BREWSTER, NY 10509-2651
(845) 277-1810
(845) 277-2851
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02705842
—
NY
Enumeration date
01/04/2006
Last updated
08/22/2020
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