Provider Demographics
NPI:1144250382
Name:DIABETIC SUPPLIES, INC.
Entity type:Organization
Organization Name:DIABETIC SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-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:614-481-9841
Mailing Address - Street 1:2140 RIVERSIDE DR STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4047
Mailing Address - Country:US
Mailing Address - Phone:614-481-9841
Mailing Address - Fax:614-481-9849
Practice Address - Street 1:2140 RIVERSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4047
Practice Address - Country:US
Practice Address - Phone:614-481-9841
Practice Address - Fax:614-481-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000335765OtherANTHEM BCBS OF OHIO
NC046WPOtherBCBS OF NORTH CAROLINA
OH2541913Medicaid
OH2541913Medicaid