Healthcare Provider Details
I. General information
NPI: 1144330135
Provider Name (Legal Business Name): DIAMOND HEALTH MANAGEMENT & STAFFING CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19111 W 10 MILE RD SUITE 231
SOUTHFIELD MI
48075-2417
US
IV. Provider business mailing address
19111 W 10 MILE RD SUITE 231
SOUTHFIELD MI
48075-2417
US
V. Phone/Fax
- Phone: 313-506-8858
- Fax:
- Phone: 248-213-4505
- Fax: 248-213-4506
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BD1200X |
| Taxonomy | Dialysis Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
MBADIWE
OGUNDU
Title or Position: PRESIDENT/CEO
Credential: ENGINEER
Phone: 248-213-4505