Organization
DIABETES SUPPLY OF CHARLOTTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA L SPARROW (OWNER)
(704) 948-9075
Entity
Organization
Contact information
Practice address
11601 ASBURY CHAPEL RD, HUNTERSVILLE, NC 28078-4631
(704) 948-9075
(704) 948-1509
Mailing address
11601 ASBURY CHAPEL RD, HUNTERSVILLE, NC 28078-4631
(704) 948-9075
(704) 948-1509
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00713501A
—
GA
01
—
0421G
BCBS PROVIDER NUMBER
NC
05
—
0440545
—
MS
01
—
20543855
BCBS PROVIDER NUMBER
GA
05
—
7701782
—
NC
05
—
DM0863
—
SC
Enumeration date
12/05/2005
Last updated
08/22/2020
Update your record
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