Provider Demographics
NPI:1346341823
Name:DIAMOND MEDICAL EQUIPMENT & SUPPLY, INC
Entity Type:Organization
Organization Name:DIAMOND MEDICAL EQUIPMENT & SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-225-3106
Mailing Address - Street 1:300 S RODNEY PARHAM RD STE 16
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4774
Mailing Address - Country:US
Mailing Address - Phone:501-225-3106
Mailing Address - Fax:501-687-0175
Practice Address - Street 1:300 S RODNEY PARHAM RD STE 16
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4774
Practice Address - Country:US
Practice Address - Phone:501-225-3106
Practice Address - Fax:501-687-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1346341823332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1028730OtherUHC
AR48352OtherAR BCBS
AR5324560OtherAETNA
AR120834716Medicaid
0259090001Medicare NSC