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NPI Code Detail

MEDICARE: DIVERSIFIED BUSINESS SERVICES, INC

MEDICARE: DIVERSIFIED BUSINESS SERVICES, INC
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
1171W00000XContractor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1167511OTHEROROMAP IDENTIFICATION NUMBE

General Provider Information

NPI Number : 1235334079
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVERSIFIED BUSINESS SERVICES, INC
Provider Business Mailing Address
First Line : PO BOX 267
Second Line :
City : BEND
State : OR
Zip : 97709-0267
Country : US
Telephone Number : 541-312-4591
Fax Number :
Provider Business Practice Location Address
First Line : 1750 SW SKYLINE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97221-2533
Country : US
Telephone Number : 541-312-4591
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : TRACY HAMAKER
Credential :
Telephone Number : 541-312-4591
Provider Enumeration Date : 06/20/2007
Last Update Date : 08/22/2020

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Directions to “DIVERSIFIED BUSINESS SERVICES, INC ” Practice Location

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