Provider Demographics
NPI:1720049315
Name:DIAMOND DRUGS, INC.
Entity Type:Organization
Organization Name:DIAMOND DRUGS, INC.
Other - Org Name:DIAMOND DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZILNER
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:724-349-1111
Mailing Address - Street 1:645 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-349-1111
Mailing Address - Fax:724-349-2984
Practice Address - Street 1:841 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3660
Practice Address - Country:US
Practice Address - Phone:724-469-3440
Practice Address - Fax:724-463-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
PAPP412358L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007666550002Medicaid
PA0007666550002Medicaid