DIABETIC SUPPLY SOURCE, INC (NPI# 1710022322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710022322 |
| Entity Type | Organization |
| Organization Name | DIABETIC SUPPLY SOURCE, INC |
| Practice Address |
2805 Millwood Ave Columbia SC 29205-1298 |
| Mailing Address |
Po Box 25534 Columbia SC 29224-5534 |
| Practice Telephone | 8037993505 |
| Practice Fax Number | 8032561083 |
| Mailing Telephone | 8037993505 |
| Mailing Fax Number | 8032561083 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN SHUFORD (OWNER) |
| Authorized Official Telephone | 8037993505 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
50-008619 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 786194 | 05 | |
| SC | NCPDP | 4226292 | 01 |
| SC | PHARMACY PERMIT NUMBER | 50-008619 | 01 |
| Street Address |
2805 MILLWOOD AVE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29205-1298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508893009 | Diabetic Supply Source, Inc Dba Dss Medical | Durable Medical Equipment & Medical Supplies | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2006-06-28 |
| 1447864798 | Chayah Stoneberg | Social Worker | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2020-09-03 |
| 1689298531 | Mary Etta Castles | Behavioral Analyst | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2020-06-05 |
| 1801426473 | Olivia Adrianna Sitton | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2020-01-22 |
| 1659911808 | Sara Pitt Plowden | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2020-01-15 |
| 1689224800 | Kiaya Aki Demonbreun | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2019-09-19 |
| 1457817520 | Ayanna Mcneil | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2019-02-13 |
| 1669944567 | Maryann Cruz | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2018-12-18 |
| 1447721022 | Kathryn Linich | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2018-12-07 |
| 1578807749 | Jessica Pena | Counselor | 2805 Millwood Ave, Columbia, SC 29205-1298 | 2012-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462241 | New Life Home Care LLC | In Home Supportive Care | 4423 Ste. D, Devine Street, Columbia, SC 29205 | 2019-11-25 |
| 1689144222 | Jessica M Jarman LLC | Counselor | 610 Holly St., Columbia, SC 29205 | 2018-11-27 |
| 1073083648 | Christopher James Troyer | Psychologist | 2805 Millwood Ave., Columbia, SC 29205 | 2018-11-27 |
| 1891277505 | Daniel Long | Pharmacist | 630 Kilbourne Road, Columbia, SC 29205 | 2018-08-30 |
| 1699126136 | Steven Matthew Ferrufino | Counselor | 417 S Edisto Ave, Columbia, SC 29205 | 2016-06-27 |
| 1619351863 | Deangela Lenore Delaney | Nurse Practitioner | 2739 Laurel Street, Columbia, SC 29205 | 2015-07-17 |
| 1548677131 | Maegan Elizabeth Dean | Pharmacist | 2708 Rosewood Drive, Columbia, SC 29205 | 2014-07-16 |
| 1144561465 | Abby Habicht | Speech-Language Pathologist | 705 Maple St., H 102, Columbia, SC 29205 | 2013-03-12 |
| 1750630562 | Pamela B. Robertson | Pharmacist | 3312 Devine Street, Columbia, SC 29205 | 2012-09-07 |
| 1609124023 | Kristen Anne Tice | Dietitian, Registered | 1029 Deerwood Street, Columbia, SC 29205 | 2012-08-15 |
| Find all providers in zip 29205 | ||||
| Taxonomy Code | 3336M0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Mail Order Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043472145 | Caremark, L.L.C. | Pharmacy | 8945 Guilford Rd, Suite 110, Columbia, MD 21046-2659 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902374598 | Manifest Pharmacy, LLC | Pharmacy | 1018 S Batesville Rd Bldg 4-a, Greer, SC 29650-4586 | 2018-11-13 |
| 1447745773 | Roshonda Morrison | Pharmacy | 10 Quail Ridge Dr, Beaufort, SC 29906-9060 | 2018-06-28 |
| 1497039390 | Medical University Hospital Authority | Pharmacy | 230 Albemarle Rd, Wh 126, Charleston, SC 29407-7522 | 2011-10-11 |
| 1952612848 | Peacock Pharmacy LLC | Pharmacy | 2099 E Main St Ste G, Duncan, SC 29334-8886 | 2010-06-25 |
| 1942528278 | Peacock Pharmacy LLC | Pharmacy | 550 S Church St Ste 9, Spartanburg, SC 29306-3306 | 2010-05-11 |
| 1073847463 | Piggly Wiggly Retail Stores, Inc. | Pharmacy | 4430 Hwy. 17 Bypass, Murrell's Inlet, SC 29576 | 2009-10-01 |
| 1669515763 | At Home Pharmacy | Pharmacy | 112 White Oak Ln # J, Lexington, SC 29073-9465 | 2007-02-15 |
| 1124011226 | Aftercare Home Medical Equipment Inc | Pharmacy | 316 S Congress St, Winnsboro, SC 29180-1404 | 2005-08-24 |
| 1770994956 | Apothecorp LLC | Pharmacy | 1393 Celanese Rd, Rock Hill, SC 29732-1722 | 2014-05-09 |
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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.