Provider Demographics
NPI:1285358309
Name:BESLO DIABETES CONSULTING, LLC
Entity type:Organization
Organization Name:BESLO DIABETES CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARICO
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:984-206-4510
Mailing Address - Street 1:PO BOX 11964
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-1964
Mailing Address - Country:US
Mailing Address - Phone:984-206-4510
Mailing Address - Fax:
Practice Address - Street 1:113 BRACKET POINT CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-6138
Practice Address - Country:US
Practice Address - Phone:984-206-4510
Practice Address - Fax:919-999-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty