Provider Demographics
NPI:1447451984
Name:DIABETES INSTITUTE INC
Entity type:Organization
Organization Name:DIABETES INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-776-1111
Mailing Address - Street 1:623 W MOULTRIE
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315
Mailing Address - Country:US
Mailing Address - Phone:870-776-1111
Mailing Address - Fax:870-776-1441
Practice Address - Street 1:623 W MOULTRIE
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315
Practice Address - Country:US
Practice Address - Phone:870-776-1111
Practice Address - Fax:870-776-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies