Provider Demographics
NPI:1508064734
Name:DIAMOND MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:DIAMOND MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-999-1900
Mailing Address - Street 1:5231 W WOODMILL DR STE 45
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4068
Mailing Address - Country:US
Mailing Address - Phone:302-999-1900
Mailing Address - Fax:
Practice Address - Street 1:5231 W WOODMILL DR STE 45
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-999-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2006206805332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies