NPI 1861701062 · live from the CMS NPI Registry
Diabetic Life Academy, LLC
Durable Medical Equipment & Medical Supplies in Las Vegas, NV. National Provider Identifier 1861701062, active.
NPI record
| NPI | 1861701062 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Durable Medical Equipment & Medical Supplies 332B00000X |
| Practice location | 4270 S. Decatur Blvd., Suite B-1b, Las Vegas, NV 89103 |
| Practice phone | 702-880-9500 |
| Enumerated | October 5, 2010 |
| Last updated | January 14, 2011 |
| Authorized official | Brandy Mosley, Office Manager/Compliance Officer |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | 2061-0219 (NV) |
| Point of Service | 305S00000X | 2061-0219 (NV) |
| Durable Medical Equipment & Medical Supplies primary | 332B00000X | 2000394-810 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.