Provider Demographics
NPI:1720667025
Name:DILIGENT MEDICAL SUPPLY
Entity Type:Organization
Organization Name:DILIGENT MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:NKAFU
Authorized Official - Last Name:NJIKEM
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:347-607-7031
Mailing Address - Street 1:5757 BOOTH RD BLDG 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5981
Mailing Address - Country:US
Mailing Address - Phone:904-425-1414
Mailing Address - Fax:904-425-2055
Practice Address - Street 1:5757 BOOTH RD BLDG 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5981
Practice Address - Country:US
Practice Address - Phone:904-425-1414
Practice Address - Fax:904-425-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies