Healthcare Provider Details

I. General information

NPI: 1578609327
Provider Name (Legal Business Name): DIAMOND RESPIRATORY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 PALMYRITA AVE
RIVERSIDE CA
92507-1600
US

IV. Provider business mailing address

1403 PALMYRITA AVE
RIVERSIDE CA
92507-1600
US

V. Phone/Fax

Practice location:
  • Phone: 951-686-0418
  • Fax: 951-686-9568
Mailing address:
  • Phone: 951-686-0418
  • Fax: 951-686-9568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number44608
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPHY43587
License Number StateCA

VIII. Authorized Official

Name: MR. CHRIS M RICE
Title or Position: PRESIDENT
Credential:
Phone: 951-686-0418