Healthcare Provider Details

I. General information

NPI: 1851866248
Provider Name (Legal Business Name): DULUMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 LAKESIDE CT STE 209
RENO NV
89509-4896
US

IV. Provider business mailing address

3500 LAKESIDE CT STE 209
RENO NV
89509-4896
US

V. Phone/Fax

Practice location:
  • Phone: 775-440-6244
  • Fax: 775-384-9987
Mailing address:
  • Phone: 775-440-6244
  • Fax: 775-384-9987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY LOWE-REYNOLDS
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 775-440-6244