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General NPI Number Information
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NPI Number | 1043482086
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Entity Type | Organization
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Legal Business Name | DIAMOND CAB, LLC
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 1407 W PLEASURE AVE
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City | SEARCY
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State | AR
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Zip | 72143-5154
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Country | US
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Telephone | 501-278-4996
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Fax | 501-278-5136
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Provider Business Mailing Address
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Address Line | 101 WESTON DR
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City | SEARCY
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State | AR
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Zip | 72143-7054
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Country | US
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Telephone | 501-278-4996
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Fax | 501-278-5136
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY DAVIS
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Credential |
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Telephone | 501-278-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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