MEDICARE: DIAMOND MILINE

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
1	374U00000X	Home Health Aide		OH

General Provider Information

NPI Number	:	1750258141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIAMOND MILINE

Provider Business Mailing Address
First Line	:	4036 BARONSMERE CT
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-1401
Country	:	US
Telephone Number	:	937-304-2527
Fax Number	:

Provider Business Practice Location Address
First Line	:	4036 BARONSMERE CT
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-1401
Country	:	US
Telephone Number	:	937-304-2527
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/20/2025

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Directions to “ DIAMOND MILINE ” Practice Location

Language	Start Address	Practice Location

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