Organization
HOME CARE DIABETES MEDICAL SUPPLY
Active
Other names
Home Care Diabetes Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE MARIE CHENAULT NONE (MANAGER)
(618) 277-1628
Entity
Organization
Contact information
Practice address
1707 10TH FAIRWAY DR, BELLEVILLE, IL 62220-4866
(618) 277-1628
(618) 277-2856
Mailing address
PO BOX 8429, BELLEVILLE, IL 62222-8429
(618) 277-1628
(618) 277-2826
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/01/2006
Last updated
09/16/2008
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