Organization
DIABETIC SUPPLY FOUNDATION OF 94 INC
Active
Other names
Diabetic Supply of 94 Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SONYA K MCGEE (OWNER)
(704) 875-0733
Entity
Organization
Contact information
Practice address
124A HUNTERSVILLE CONCORD RD, HUNTERSVILLE, NC 28078-6215
(704) 875-0733
(704) 948-9704
Mailing address
PO BOX 976, HUNTERSVILLE, NC 28070-0976
(704) 875-0733
(704) 948-9704
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009113126
—
VA
01
—
0463E
BCBLUE SHIELD PROVIDER ID
NC
05
—
77701560
—
NC
05
—
DM0661
—
SC
Enumeration date
03/07/2006
Last updated
03/02/2010
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