Healthcare Provider Details

I. General information

NPI: 1952485203
Provider Name (Legal Business Name): DIAMOND SCOOTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S MILL RD STE 1
ABSECON NJ
08201-4802
US

IV. Provider business mailing address

645 S. MILL RD SUITE 7
ABSECON NJ
08201-4802
US

V. Phone/Fax

Practice location:
  • Phone: 856-528-9366
  • Fax: 609-646-4447
Mailing address:
  • Phone: 856-528-9366
  • Fax: 609-646-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: CASSIDY R. PENN
Title or Position: HUMAN RESOURCES
Credential:
Phone: 856-528-9366