| Name: | Diabetes Store, Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Exists |
| Date of registration: | 09 Apr 2002 (23 years ago) (Companies founded in April 2002) |
| Entity Number: | 001-096-862 |
| Register Number: | 001096862 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Tennessee |
| Principal Address: | 1760 MORIAH WOODS BLVD #2MEMPHIS, TN 38117 |
| Registered Office Street Address: | 2 NORTH JACKSON STREETSUITE 605MONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578867388 | 2011-01-08 | 2022-11-11 | 1760 MORIAH WOODS BLVD STE 2, MEMPHIS, TN, 381177128, US | 3349 INDEPENDENCE DR STE 105, HOMEWOOD, AL, 352098328, US | |||||||||||||||||||||||||||||
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| Phone | +1 901-312-3150 |
| Fax | 8002080863 |
| Phone | +1 205-263-3951 |
Authorized person
| Name | CRAIG BROSSEAU |
| Role | SECRETARY |
| Phone | 9526463255 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | 4425570003 |
| State | AL |
| Issuer | MEDICAID |
| Number | 240932 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
