Provider Demographics
NPI:1235334079
Name:DIVERSIFIED BUSINESS SERVICES, INC
Entity Type:Organization
Organization Name:DIVERSIFIED BUSINESS SERVICES, INC
Other - Org Name:DBS HEALTH INFORMATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-312-4591
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0267
Mailing Address - Country:US
Mailing Address - Phone:541-312-4591
Mailing Address - Fax:
Practice Address - Street 1:1750 SW SKYLINE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2533
Practice Address - Country:US
Practice Address - Phone:541-312-4591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR167511OtherOMAP IDENTIFICATION NUMBE