Organization · NPI-2

Advanced Diabetic Solutions LLC

Durable Medical Equipment & Medical Supplies · Lawrenceville, GA

NPI number1750480901
StatusActive
Last updated in NPPESSep 30, 2015

Details

NPI
1750480901
Entity type
Organization (NPI-2)
Legal business name
Advanced Diabetic Solutions LLC
Organization subpart
No
Enumeration date
Sep 22, 2006
Last updated
Sep 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies––Yes
225000000X Orthotic FitterC49737MD
222Z00000X 13GA
224L00000X PedorthistCPed2905DE
224L00000X PedorthistCPed1966DE
224900000X Mastectomy FitterCFm01708DE

Practice location

1580 Atkinson Rd
Lawrenceville, GA 30043-5600

Phone 770-339-1190 · Fax 770-339-1192

Mailing address

1580 Atkinson Rd
Lawrenceville, GA 30043-5600

Phone 770-339-1190 · Fax 770-339-1192

Authorized official

Gregory Peter Santulli
President
7703391190

Is something wrong?

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