Organization
TRIANGLE DIABETIC SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM W CHURCHILL (OWNER)
(919) 562-0007
Entity
Organization
Contact information
Practice address
1000 BRACKEN CT, WAKE FOREST, NC 27587-9358
(919) 562-0007
(919) 562-4670
Mailing address
1000 BRACKEN CT, WAKE FOREST, NC 27587-9358
(919) 562-0007
(919) 562-4670
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703504
—
NC
Enumeration date
05/17/2007
Last updated
08/22/2020
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