DIABETIC LIFE SUPPLY, LLC. (NPI# 1629264429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629264429 |
| Entity Type | Organization |
| Organization Name | DIABETIC LIFE SUPPLY, LLC. |
| Practice Address |
4270 S Decatur Blvd Ste. B1-b Las Vegas NV 89103-6802 |
| Practice Telephone | 7028809500 |
| Practice Fax Number | 7028809507 |
| Mailing Telephone | 7028809500 |
| Mailing Fax Number | 7028809507 |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2010-06-24 |
| Authorized Official Name | MR. ROBERT EDWARD MILLER JR. (CEO) |
| Authorized Official Telephone | 7028809500 |
| 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 |
|---|---|---|---|
| NV | 100513194 | 05 |
| Street Address |
4270 S DECATUR BLVD STE. B1-B |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89103-6802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447406 | Shaheen Waqar Ahmad | Nurse Practitioner | 4270 S Decatur Blvd, Las Vegas, NV 89103-6800 | 2020-08-11 |
| 1851894489 | Christine Barnett | Nurse Practitioner | 4270 S Decatur Blvd, Las Vegas, NV 89103-6800 | 2018-03-09 |
| 1710361894 | Milestone Dental | Dentist | 4270 S Decatur Blvd, Suite A2, Las Vegas, NV 89103-6800 | 2015-07-17 |
| 1922273101 | Rapid Care Medical Clinic, LLC. | Physical Medicine & Rehabilitation | 4270 S Decatur Blvd, Suite A-1a, Las Vegas, NV 89103-6800 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1396356929 | A-plus Community Counseling Services LLC | Counselor | 3651 S Lindell Dr Ste D15, Las Vegas, NV 89103 | 2020-08-17 |
| 1437798931 | Las Vegas Diagnostic & Treatment LLC | Neuromusculoskeletal Medicine & OMM | Dpm, 5650 W Flamingo Rd Ste A, Las Vegas, NV 89103 | 2019-12-31 |
| 1033769385 | Maria Yemi Centeno | Technician | 4674 Via Torino, Las Vegas, NV 89103 | 2019-09-18 |
| 1750847869 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3821 W Flamingo Rd, Las Vegas, NV 89103 | 2019-02-13 |
| 1447741905 | Adgold Medical Corp | Durable Medical Equipment & Medical Supplies | 3651 Lindell Rd Ste D536, Las Vegas, NV 89103 | 2018-05-21 |
| 1184138620 | Kiley Ballew | Social Worker | 4425 South Jones, Suite D3, Las Vegas, NV 89103 | 2017-11-20 |
| 1396275988 | Karen Walton | Technician | 5419 W. Tropicana Ave. A2803, Las Vegas, NV 89103 | 2017-06-15 |
| 1760923643 | Shannon-dorothy Austria | Social Worker | 4425 S. Jones, Suite D3, Las Vegas, NV 89103 | 2017-03-13 |
| 1306260583 | Ladonna Smith | Behavioral Analyst | 1126 Tamerck Ave, Las Vegas, NV 89103 | 2014-02-10 |
| Find all providers in zip 89103 | ||||
| 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 |
|---|---|---|---|---|
| 1811595622 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2500 W Washington Ave Ste 103, Las Vegas, NV 89106-3731 | 2020-10-14 |
| 1639793698 | Amador Medical LLC | Durable Medical Equipment & Medical Supplies | 4325 Dean Martin Dr Ste 340, Las Vegas, NV 89103-4168 | 2020-06-04 |
| 1205456001 | Vitality M12 LLC | Durable Medical Equipment & Medical Supplies | 4650 Arville St Ste F, Las Vegas, NV 89103-5325 | 2020-04-21 |
| 1255951059 | Peggy Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 6355 S Durango Dr Unit 1265, Las Vegas, NV 89113-1878 | 2020-04-21 |
| 1598394801 | Total Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 200 Hoover Ave Unit 1912, Las Vegas, NV 89101-6887 | 2020-04-07 |
| 1033743083 | Summerlin Medical | Durable Medical Equipment & Medical Supplies | 10300 W. Charleston Blvd., Suite 13, Las Vegas, NV 89135 | 2020-02-28 |
| 1053959791 | Wound Pros Nevada | Durable Medical Equipment & Medical Supplies | 5940 S Rainbow Blvd Ste 2007, Las Vegas, NV 89118-2506 | 2019-12-12 |
| 1841835618 | Home Front Pumps West | Durable Medical Equipment & Medical Supplies | 11239 Cactus Tower Ave Unit 101, Las Vegas, NV 89135-3449 | 2019-11-15 |
| 1568016855 | Medelite Capital, LLC | Durable Medical Equipment & Medical Supplies | 5528 S Fort Apache Rd, Las Vegas, NV 89148-7657 | 2019-07-25 |
| 1376004614 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2780 S Jones Blvd Ste 140, Las Vegas, NV 89146-5641 | 2019-03-28 |
| Find all providers in LAS VEGAS | ||||
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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.