LAKE DIABETES SUPPLY, INC (NPI# 1861487191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861487191 |
Entity Type | Organization |
Organization Name | LAKE DIABETES SUPPLY, INC |
Practice Address |
2555 S Atlantic Ave Suite 1205 Daytona Beach Shores FL 32118-5546 |
Mailing Address |
508 N Harbor City Blvd Melbourne FL 32935-6838 |
Practice Telephone | 3863045941 |
Practice Fax Number | 3863045941 |
Mailing Telephone | 3212559800 |
Mailing Fax Number | 3217511145 |
Enumeration Date | 2005-09-13 |
Last Update Date | 2008-10-06 |
Authorized Official Name | MR. RICHARD B HARTWELL (PRESIDENT) |
Authorized Official Telephone | 3863045941 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332B00000X | Durable Medical Equipment & Medical Supplies | ========= | FL | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | BCBS IDENTIFIER | R9283 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568763696 | Lake Diabetes Supply, Inc | Health Educator | 508 N Harbor City Blvd, Melbourne, FL 32935-6838 | 2010-11-05 |
1326033648 | Lake Diabetes Supply, Inc | Durable Medical Equipment & Medical Supplies | 2150 Collier Ave, Suite R, Fort Myers, FL 33901-8129 | 2005-09-13 |
Street Address |
2555 S ATLANTIC AVE SUITE 1205 |
City | DAYTONA BEACH SHORES |
State | FL |
Zip Code | 32118-5546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407476633 | Adel Demetrious | Dentist | 2727 North Atlantic, Ave, Suite 121, Dayton Beach, FL 32118 | 2020-04-17 |
1518433804 | Tara James | Nurse Practitioner | 224 Seabreeze Blvd, Daytona Beach, FL 32118 | 2018-10-15 |
1760835706 | Barbara Fuller | Early Intervention Provider Agency | 125 Cheshire Rd, Daytona Beach, FL 32118 | 2016-07-14 |
1821486457 | Emily Catherine Lounsbury | Nurse Practitioner | 3512 South Atlantic Avenue, Daytona Beach Shores, FL 32118 | 2015-01-06 |
1215334370 | Shores Medical Center | Nurse Practitioner | 3512 S Atlantic Blvd, Daytona Beach Shores, FL 32118 | 2014-12-04 |
1619305075 | Kimberly Barr Beck-frate | Counselor | 444 Seabreeze Blvd., Integrative Crisis Management, Suite 725, Daytona Beach, FL 32118 | 2013-10-23 |
1104190792 | Demetrius Marketing LLC | Dentist | 2570 South Atlantic Ave., Marina Dental Center, Daytona Beach Shores, FL 32118 | 2012-02-29 |
1255603189 | A1a Medical | General Practice | 1401 North Atlantic Avenue, Daytona Beach, FL 32118 | 2012-02-08 |
1184755654 | David Gaughan | Physical Medicine & Rehabilitation | 3512 S Atlantic Av., Daytona Beach Shores, FL 32118 | 2007-03-08 |
1952497612 | Ability Health Services, Inc | Durable Medical Equipment & Medical Supplies | 614 N. Penisula Dr, Daytona Beach, FL 32118 | 2006-10-04 |
Find all providers in zip 32118 |
Taxonomy Code | 332B00000X |
Grouping | Suppliers |
Classification | Durable Medical Equipment & Medical Supplies |
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326443060 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 3044 S Atlantic Ave, Daytona Beach Shores, FL 32118-6102 | 2014-10-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184225047 | Halo Florida Dme LLC | Durable Medical Equipment & Medical Supplies | 710 Pondella Rd Ste 4, North Fort Myers, FL 33903-5730 | 2020-11-05 |
1033710249 | Harmony Home Care Solutions LLC | Durable Medical Equipment & Medical Supplies | 6625 Miami Lakes Dr E Ste 319, Miami Lakes, FL 33014-2705 | 2020-11-04 |
1972104305 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 8684 Beulah Rd, Pensacola, FL 32526-5201 | 2020-11-03 |
1548861990 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 2135 Everglades Ln, The Villages, FL 32163-1037 | 2020-11-03 |
1588265961 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 555 Channelside Dr, Tampa, FL 33062 | 2020-11-03 |
1659972016 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 5140 County Line Rd, Lakeland, FL 33811-1706 | 2020-11-03 |
1891396248 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 205 Rivertown Shops Dr, Saint Johns, FL 32259-7476 | 2020-11-03 |
1326649781 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 930 North Miami Beach Blvd, North Miami Beach, FL 33162 | 2020-11-03 |
1265033591 | Acqualina Health Medical Solutions, Inc. | Durable Medical Equipment & Medical Supplies | 12955 Biscayne Blvd Ste 322, North Miami, FL 33181-2022 | 2020-11-03 |
1083215511 | Supplies Plus Fl Inc | Durable Medical Equipment & Medical Supplies | 223 Island Way Apt 5f, Clearwater Beach, FL 33767-2254 | 2020-11-02 |
Find all providers with the same taxonomy |
City | DAYTONA BEACH SHORES |
Zip Code | 32118 |
Please comment or provide details below to improve the information on LAKE DIABETES SUPPLY, INC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.