Provider Demographics
NPI:1043482086
Name:DIAMOND CAB, LLC
Entity Type:Organization
Organization Name:DIAMOND CAB, LLC
Other - Org Name:DIAMOND TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-278-4996
Mailing Address - Street 1:101 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7054
Mailing Address - Country:US
Mailing Address - Phone:501-278-4996
Mailing Address - Fax:501-278-5136
Practice Address - Street 1:1407 W PLEASURE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5154
Practice Address - Country:US
Practice Address - Phone:501-278-4996
Practice Address - Fax:501-278-5136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)