SPECTRUM DIABETIC SERVICES, LLC (NPI# 1417094467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417094467 |
| Entity Type | Organization |
| Organization Name | SPECTRUM DIABETIC SERVICES, LLC |
| Practice Address |
3634 Mccain Rd Suite #4 Jackson MI 49203-2576 |
| Practice Telephone | 5177834116 |
| Practice Fax Number | 5177834885 |
| Mailing Telephone | 5177834116 |
| Mailing Fax Number | 5177834885 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2012-09-20 |
| Authorized Official Name | MR. JON PAUL LETKO (PRESIDENT) |
| Authorized Official Telephone | 8664584116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | 540C811880 | 01 |
| MI | 5190006 | 05 |
| Street Address |
3634 MCCAIN RD SUITE #4 |
| City | JACKSON |
| State | MI |
| Zip Code | 49203-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720165095 | Scott Martin Manchester | Chiropractor | 3634 Mccain Rd, Unit 7, Jackson, MI 49203-2576 | 2006-11-01 |
| 1548664741 | Jonathan Curtis | Chiropractor | 3634 Mccain Rd, Unit 7, Jackson, MI 49203-2576 | 2014-10-16 |
| 1790029874 | Manchester Family Chiropractic Center Plc | Chiropractor | 3634 Mccain Rd, Unit 7, Jackson, MI 49203-2576 | 2012-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
| 1407224280 | Lucinda Gail Taggart | Licensed Practical Nurse | 1515 Greenwood Ave., Jackson, MI 49203 | 2015-09-10 |
| 1134514045 | Christopher Dauterman | Registered Nurse | 1320 East Mcdevitt, Jackson, MI 49203 | 2015-03-30 |
| 1710386826 | Steven Andrew Edwards | Social Worker | 505 Hickory Court, #2d, Jackson, MI 49203 | 2014-08-14 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1497014831 | Barbara Cliffe-miller | Physical Therapist | 3510 Page Ave, Jackson, MI 49203 | 2012-05-04 |
| 1871822718 | Sharon Ann Arendsen | Respite Care | 4043 Clarkway Rd, Jackson, MI 49203 | 2009-12-23 |
| 1669700456 | Teresa Lynn Cox | Technician, Other | 3884 Franklin Rd., Jackson, MI 49203 | 2009-12-07 |
| 1942537097 | Stacy Marie Chinevere I | Counselor | 326 Johnson St, Jackson, MI 49203 | 2009-11-11 |
| 1366672370 | Sarah Elizabeth Hazlett | Counselor | 1522joy Avenue, Jackson, MI 49203 | 2009-07-24 |
| Find all providers in zip 49203 | ||||
| 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 |
|---|---|---|---|---|
| 1700432754 | Encore Care Inc | Durable Medical Equipment & Medical Supplies | 55 N County Line Rd Ste 6, Jackson, NJ 08527-1394 | 2019-08-15 |
| 1720542855 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 1200 N State St Ste 110, Jackson, MS 39202-2027 | 2019-01-23 |
| 1689142317 | 3 B Labs | Durable Medical Equipment & Medical Supplies | 3011 Greystone Sq, Jackson, TN 38305-3590 | 2018-11-12 |
| 1043726896 | Elite Medical Supply | Durable Medical Equipment & Medical Supplies | 1166 Greenway Dr Ste A3, Jackson, MO 63755-2919 | 2017-12-15 |
| 1124551205 | Quincy Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 5303 Old Cape Rd E Ste A, Jackson, MO 63755-3850 | 2017-04-06 |
| 1295277952 | G & N Enterprise, LLC | Durable Medical Equipment & Medical Supplies | 460 Briarwood Dr Ste 100, Jackson, MS 39206-3053 | 2016-11-12 |
| 1417305665 | J.u.s.t. Orthotics | Durable Medical Equipment & Medical Supplies | 1020 Aspen Dr, Jackson, MO 63755-1152 | 2016-05-27 |
| 1710332325 | Apex Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 189 N Lacey St, Suite 2, Jackson, MO 63755-2496 | 2016-05-02 |
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1285099192 | At-home Medical Supply | Durable Medical Equipment & Medical Supplies | 5015 I 55 N Ste B, Jackson, MS 39206-4306 | 2015-12-18 |
| Find all providers in JACKSON | ||||
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| 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.