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DIABETIC SHOE SOURCE
NPI 1003960147
Durable Medical Equipment & Medical Supplies in Eagan, MN

Active since January 23, 2007
2121 CLIFF DR STE 118, EAGAN, MN 55122(763) 757-8086(763) 862-4797 Get Directions Write a Review

NPPES record last updated: October 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 21, 2021, Oct 13, 2021, Sep 14, 2021 (3 updates tracked since 2021).

About Diabetic Shoe Source NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIABETIC SHOE SOURCE (NPI 1003960147) is a healthcare organization registered as a durable medical equipment & medical supplies in Eagan, Minnesota and active in the NPI registry since January 2007. The organization lists Amy Luzaich, President, as its authorized official.

NPPES Registry Identity

NPI1003960147
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameDIABETIC SHOE SOURCE
Location Address2121 CLIFF DR STE 118Eagan, MN 55122-3431
Mailing Address2121 Cliff Dr Ste 118Eagan, MN 55122-3431 · (763) 757-8086 · Fax (763) 862-4797
Phone(763) 757-8086
Fax(763) 862-4797
Organization SubpartNo
Authorized OfficialAmy LuzaichPresident · (763) 757-8086
Enumeration DateJanuary 23, 2007
Last NPPES UpdateOctober 21, 20213 updates tracked since enumeration
NPPES CertifiedOctober 21, 2021
✔ NPI 1003960147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
2121 CLIFF DR STE 118, Eagan, MN 55122
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Other Identifiers 2

Medicaid520052200MN
Other786A6DIMN · Bcbs

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diabetic Shoe Source's NPI number?

The NPI number for Diabetic Shoe Source is 1003960147. It was assigned to this organization in the NPPES registry on January 23, 2007.

Where is Diabetic Shoe Source located?

Diabetic Shoe Source is located at 2121 Cliff Dr Ste 118, Eagan, MN 55122. The listed phone number is (763) 757-8086.

What is Diabetic Shoe Source's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Diabetic Shoe Source was last updated on October 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.