Organization
DEEPAL CEMO MEDICAL SOLUTIONS, LLC
Active
Organization
DEEPAL CEMO MEDICAL SOLUTIONS, LLC
Active
Other names
American Diabetes Therapy Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L. ZWECK (VICE PRESIDENT)
(916) 933-2300
Entity
Organization
Contact information
Practice address
945 ROSEVILLE PARKWAY, SUITE 150, ROSEVILLE, CA 95678-6063
(916) 788-8444
(916) 788-8449
Mailing address
950 GLENN DR, SUITE 250, FOLSOM, CA 95630-3130
(916) 933-2300
(916) 933-0119
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
CLR339743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2005230
CLIA WAIVER
—
01
—
CLR 339743
CALIFORNIA CLIA REGISTRATION
CA
Enumeration date
04/15/2010
Last updated
11/03/2011
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