Provider Demographics
NPI:1366590358
Name:DIAMOND DRUGS INC
Entity type:Organization
Organization Name:DIAMOND DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LOUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-349-1111
Mailing Address - Street 1:645 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-349-1111
Mailing Address - Fax:724-349-2984
Practice Address - Street 1:900 E KING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3272
Practice Address - Country:US
Practice Address - Phone:717-299-7875
Practice Address - Fax:717-209-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413860L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2081754OtherPK