Provider Demographics
NPI:1073297453
Name:BLUE DIAMOND WORKMED
Entity Type:Organization
Organization Name:BLUE DIAMOND WORKMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-789-9675
Mailing Address - Street 1:365 W 50 N STE 1
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2004
Mailing Address - Country:US
Mailing Address - Phone:435-789-6224
Mailing Address - Fax:435-789-6224
Practice Address - Street 1:365 W 50 N STE 1
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2004
Practice Address - Country:US
Practice Address - Phone:435-789-6224
Practice Address - Fax:435-789-6224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HASKINS MEDICAL SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-14
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine