Organization
LIFE CARE DIABETIC SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BIBY DAVILA JACOBY (PRESIDENT)
(561) 745-7338
Entity
Organization
Contact information
Practice address
840 JUPITER PARK DR, SUITE 101, JUPITER, FL 33458-8947
(561) 745-7335
(561) 427-6427
Mailing address
PO BOX 641, JUPITER, FL 33468-0641
(561) 745-7338
(561) 427-6427
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1312919
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000326697C
—
GA
05
—
031242800
—
FL
01
—
1312919
HME LICENSE
FL
05
—
143776601
—
TX
05
—
1469017
—
LA
05
—
200008430A
—
OK
05
—
200304520A
—
KS
05
—
401094900
—
MD
05
—
443086700
—
MI
05
—
567602
—
IA
05
—
7821760
—
NM
05
—
845265155
—
ID
05
—
90011446
—
KY
05
—
9982460
—
AL
Enumeration date
05/28/2006
Last updated
06/30/2014
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