Organization
EZ DIABETIC SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIOT M. ZIMMERMAN (PRESIDENT)
(207) 386-1080
Entity
Organization
Contact information
Practice address
61 STATE RD, WEST BATH, ME 04530-6301
(207) 386-1080
(207) 386-1088
Mailing address
61 STATE RD, WEST BATH, ME 04530-6301
(207) 386-1080
(207) 386-1088
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009975265
—
AL
05
—
010369258
—
VA
01
—
047029
ANTHEM BCBS
ME
05
—
06559353
—
MS
05
—
100249992-00
—
NE
05
—
1017916
—
VT
05
—
1344494
—
LA
05
—
155450000
—
ME
05
—
159235741
—
AR
05
—
1689677023
—
CA
05
—
1689677023
—
MI
05
—
1689677023
—
MN
05
—
1689677023
—
UT
05
—
200916420 A
—
IN
05
—
2428733
—
OH
05
—
30762818
—
NH
05
—
3810004618
—
WV
05
—
4582522
—
TN
05
—
7783934
—
PA
05
—
90013939
—
KY
05
—
DM1153
—
SC
05
—
ZERO3161800
—
NY
05
—
ZERO43692703001
—
IL
Enumeration date
05/31/2005
Last updated
04/25/2012
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