Organization
DIVERSIFIED SECURITY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ROBERT DUNCAN (OWNER)
(541) 779-5611
Entity
Organization
Contact information
Practice address
836 E MAIN ST STE 6, MEDFORD, OR 97504-7115
(541) 779-5611
(541) 779-6355
Mailing address
836 E MAIN ST STE 6, MEDFORD, OR 97504-7115
(541) 779-5611
(541) 779-6355
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028095
—
OR
Enumeration date
09/27/2006
Last updated
08/22/2020
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