Provider Demographics
NPI:1063596195
Name:DIAMOND DRUGS INC
Entity type:Organization
Organization Name:DIAMOND DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAUB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-728-2168
Mailing Address - Street 1:550 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1006
Mailing Address - Country:US
Mailing Address - Phone:516-932-3900
Mailing Address - Fax:516-932-3937
Practice Address - Street 1:550 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1006
Practice Address - Country:US
Practice Address - Phone:516-932-3900
Practice Address - Fax:516-586-8735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0212693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2063176OtherPK