Organization
DIABETIC SPECIALTIES & SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA D TAYLOR (OWNER)
(901) 577-0016
Entity
Organization
Contact information
Practice address
385 S MAIN ST, MEMPHIS, TN 38103-4238
(901) 577-0016
(901) 578-5108
Mailing address
PO BOX 3242, 385 SOUTH MAIN, MEMPHIS, TN 38173-0242
(901) 577-0016
(901) 578-5108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
770
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4582329
—
TN
Enumeration date
08/25/2005
Last updated
08/22/2020
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