LAKE DIABETES SUPPLY, INC


Address: 2555 S Atlantic Ave, Suite 1205, Daytona Beach Shores, FL 32118-5546
Phone: 3863045941

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332B00000X Durable Medical Equipment & Medical Supplies ========= FL Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
FL BCBS IDENTIFIER R9283 01

Other Provider IDs and Locations

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

Office Location

Street Address 2555 S ATLANTIC AVE
SUITE 1205
City DAYTONA BEACH SHORES
State FL
Zip Code 32118-5546

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 332B00000X
Grouping Suppliers
Classification Durable Medical Equipment & Medical Supplies

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

Search similar providers

City DAYTONA BEACH SHORES
Zip Code 32118

Improve Information

Please comment or provide details below to improve the information on LAKE DIABETES SUPPLY, INC.

Dataset Information

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.

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