Provider Demographics
NPI:1174846356
Name:UNITED DIABETIC SUPPLIES INC
Entity type:Organization
Organization Name:UNITED DIABETIC SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-349-6800
Mailing Address - Street 1:1201 US HIGHWAY 1
Mailing Address - Street 2:STE 36
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3550
Mailing Address - Country:US
Mailing Address - Phone:703-349-6800
Mailing Address - Fax:703-349-1680
Practice Address - Street 1:1201 US HIGHWAY 1
Practice Address - Street 2:STE 36
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3550
Practice Address - Country:US
Practice Address - Phone:703-349-6800
Practice Address - Fax:703-349-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies