Organization
DIABETIC SHOPPE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA RUSHING (PRESIDENT)
(334) 872-0150
Entity
Organization
Contact information
Practice address
909 HIGHLAND AVE STE B, SELMA, AL 36701-4965
(334) 872-0150
Mailing address
909 HIGHLAND AVE STE B, SELMA, AL 36701-4965
(334) 872-0150
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009914109
—
AL
Enumeration date
10/29/2007
Last updated
05/06/2008
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