Provider Demographics
NPI:1194751404
Name:UNLIMITED DIABETIC SUPPLIES, CORP.
Entity type:Organization
Organization Name:UNLIMITED DIABETIC SUPPLIES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAKHTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-231-3214
Mailing Address - Street 1:2140 RIVERSIDE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4047
Mailing Address - Country:US
Mailing Address - Phone:800-231-3214
Mailing Address - Fax:
Practice Address - Street 1:2140 RIVERSIDE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4047
Practice Address - Country:US
Practice Address - Phone:800-231-3214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4221540001Medicare ID - Type Unspecified