Diabetes Source Rx

LBN: Greenway Medical Inc.
Diabetes Source Rx is an health care organization with primary practice located at 803 Coolidge Blvd Suite 128, Lafayette LA 70503-2376. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Greenway Medical Inc. can be contacted via phone (337) 267-7470, or through Mouton, Molly via phone (337) 267-7470.

Contact Information

Primary practice address
803 Coolidge Blvd Suite 128 Lafayette LA 70503-2376
Phone: (337) 267-7470
Fax: (866) 794-5729
Website:
Map and Directions
Authorized official contact:
Name: Mouton, Molly
Phone: (337) 267-7470

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1609865773
LBN Legal business name Greenway Medical Inc.
DBA Doing business as Diabetes Source Rx
Authorized official Mouton, Molly
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2005
Last updated Apr 23rd, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609865773 NPPES
Texas MEDICAID 011633701
Texas Other G9723
Texas MEDICAID 010164401
Texas MEDICAID 1467537
Texas Other 519779

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