Provider Demographics
NPI:1588086714
Name:DIAMOND DRUGS II, INC.
Entity type:Organization
Organization Name:DIAMOND DRUGS II, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
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:DIAMOND DRUGS II, INC.
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803
Mailing Address - Country:US
Mailing Address - Phone:516-586-8733
Mailing Address - Fax:516-586-8735
Practice Address - Street 1:724 OLD BETHPAGE RD.
Practice Address - Street 2:DIAMOND DRUGS II, INC.
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804
Practice Address - Country:US
Practice Address - Phone:516-586-8733
Practice Address - Fax:516-586-8735
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIAMOND DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021269333600000X
NY0324853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy