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NPI Code Detail

MEDICARE: DIAMOND CANYON MEDICAL SUPPILES LLC.

MEDICARE: DIAMOND CANYON MEDICAL SUPPILES LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1053621383
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAMOND CANYON MEDICAL SUPPILES LLC.
Provider Business Mailing Address
First Line : 7625 E CAMELBACK RD
Second Line : UNIT 250A
City : SCOTTSDALE
State : AZ
Zip : 85251-2105
Country : US
Telephone Number : 734-560-1406
Fax Number : 734-335-7570
Provider Business Practice Location Address
First Line : 7625 E CAMELBACK RD
Second Line : UNIT 250A
City : SCOTTSDALE
State : AZ
Zip : 85251-2105
Country : US
Telephone Number : 734-560-1406
Fax Number : 734-335-7570
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : BHUPINDERJIT KAUR NIJJAR
Credential :
Telephone Number : 734-560-1406
Provider Enumeration Date : 10/20/2010
Last Update Date : 10/20/2010

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Directions to “DIAMOND CANYON MEDICAL SUPPILES LLC. ” Practice Location

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