Provider Demographics
NPI:1669470977
Name:DIAMED, INC.
Entity Type:Organization
Organization Name:DIAMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-588-8966
Mailing Address - Street 1:3670 PROGRESS ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-4438
Mailing Address - Country:US
Mailing Address - Phone:330-588-8966
Mailing Address - Fax:330-588-8179
Practice Address - Street 1:3670 PROGRESS ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-4438
Practice Address - Country:US
Practice Address - Phone:330-588-8966
Practice Address - Fax:330-588-8179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMEL 11048332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000155860OtherANTHEM BC/BS PROVIDER ID
OH91490OtherQUALCHOICE PROVIDER ID
OH2020771Medicaid
OH2020771Medicaid