Organization
A1 DIABETES & MEDICAL SUPPLY, INC.
Active
Other names
Lake Diabetes & Medical Supply, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN PEREIRA (CEO)
(321) 325-6047
Entity
Organization
Contact information
Practice address
1785 NONCONNAH BLVD, SUITE 110, MEMPHIS, TN 38132-2104
(800) 316-7955
(888) 491-3050
Mailing address
1785 NONCONNAH BLVD, SUITE 110, MEMPHIS, TN 38132-2104
(800) 316-7955
(888) 491-3050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R9284
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/07/2005
Last updated
09/16/2014
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