Provider Demographics
NPI:1275993131
Name:DOSE OF DIAMOND LLC
Entity Type:Organization
Organization Name:DOSE OF DIAMOND LLC
Other - Org Name:3D WELLNESS SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PARVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAINTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-657-2200
Mailing Address - Street 1:PO BOX 1760
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-1760
Mailing Address - Country:US
Mailing Address - Phone:352-657-2200
Mailing Address - Fax:844-888-0509
Practice Address - Street 1:3143 SW 32ND AVE STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4404
Practice Address - Country:US
Practice Address - Phone:352-657-2200
Practice Address - Fax:844-888-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X, 3336S0011X
FLPH298943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2159960OtherPK