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DIABETIC SUPPLY SOURCE INC NPI 1710022322


NPI Information

NPI: 1710022322
Provider Name: DIABETIC SUPPLY SOURCE, INC
Classification: Pharmacy - 3336M0002X
Entity Type: Organization

Specialization: Mail Order Pharmacy

Address:
2805 MILLWOOD AVE
COLUMBIA, SC
ZIP 29205
Phone: (803) 799-3505
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DIABETIC SUPPLY SOURCE, INC is a mail order pharmacy pharmacy in Columbia, SC. The provider is a pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Mail order pharmacies counsel patients and caregivers (sometimes independent of the dispensing process) through telephone or email contact and provide other professional services associated with pharmaceutical care appropriate to the setting. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states. DIABETIC SUPPLY SOURCE, INC NPI is 1710022322. The provider is registered as an organization entity type.

The provider's business location address is:

2805 MILLWOOD AVE
COLUMBIA, SC
ZIP 29205-298
Phone: (803) 799-3505
Fax: (803) 256-1083

The provider's authorized official is John Shuford .
The authorized official title is Owner and has the following contact phone number (803) 799-3505.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336M0002XPharmacyMail Order Pharmacy50-008619SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1786194MEDICAIDSOUTH CAROLINA
24226292OTHERSOUTH CAROLINANCPDP
350-008619OTHERSOUTH CAROLINAPHARMACY PERMIT NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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