Provider Demographics
NPI:1780664730
Name:DIAMOND MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:DIAMOND MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIURKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-356-5944
Mailing Address - Street 1:6205 ABERCORN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5527
Mailing Address - Country:US
Mailing Address - Phone:912-356-5944
Mailing Address - Fax:912-356-5946
Practice Address - Street 1:6205 ABERCORN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5527
Practice Address - Country:US
Practice Address - Phone:912-356-5944
Practice Address - Fax:912-356-5946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5374710001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT