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General NPI Number Information
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NPI Number | 1164455804
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Entity Type | Organization
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Legal Business Name | DIAMOND E, ICN.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1205 W BESSEMER AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-8442
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Country | US
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Telephone | 336-279-8814
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Fax | 336-279-8424
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Provider Business Mailing Address
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Address Line | 1205 W BESSEMER AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-8442
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Country | US
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Telephone | 336-279-8814
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Fax | 336-279-8424
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. ERNEST C GARRETT JR.
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Credential |
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Telephone | 336-279-8814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC1000
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License Number State | NC
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