Diabetic Shoe Source
Durable Medical Equipment & Medical Supplies in Eagan, MN. Organization (NPI-2).
Details
- NPI
- 1003960147
- Entity type
- Organization (NPI-2)
- Legal business name
- Diabetic Shoe Source
- Organization subpart
- No
- Enumeration date
- Jan 23, 2007
- Certification date
- Oct 21, 2021
- Last updated
- Oct 21, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
2121 Cliff Dr Ste 118Eagan, MN 55122-3431
Phone 763-757-8086 · Fax 763-862-4797
Mailing address
2121 Cliff Dr Ste 118Eagan, MN 55122-3431
Phone 763-757-8086 · Fax 763-862-4797
Authorized official
Amy Luzaich
President
7637578086
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 15 Durable Medical Equipment & Medical Supplies providers in Eagan · All 2,108 providers in Eagan
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