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General NPI Number Information
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NPI Number | 1053621383
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Entity Type | Organization
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Legal Business Name | DIAMOND CANYON MEDICAL SUPPILES LLC.
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 7625 E CAMELBACK RD UNIT 250A
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2105
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Country | US
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Telephone | 734-560-1406
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Fax | 734-335-7570
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Provider Business Mailing Address
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Address Line | 7625 E CAMELBACK RD UNIT 250A
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2105
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Country | US
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Telephone | 734-560-1406
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Fax | 734-335-7570
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | BHUPINDERJIT KAUR NIJJAR
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Credential |
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Telephone | 734-560-1406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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