MEDICARE: DIAMONAIRE SCREENING SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1356119622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAMONAIRE SCREENING SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3626 FAIR OAKS BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-7200
Country	:	US
Telephone Number	:	888-838-5538
Fax Number	:

Provider Business Practice Location Address
First Line	:	3626 FAIR OAKS BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-7200
Country	:	US
Telephone Number	:	888-838-5538
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANDREA M HODGES
Credential	:	MA
Telephone Number	:	888-838-5538

Provider Enumeration Date	:	12/18/2023
Last Update Date	:	12/18/2023

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