Organization
DIAMOND STAR MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA GAIL DAVIS (MANAGER)
(904) 755-2367
Entity
Organization
Contact information
Practice address
1300 HAWKS CREST DR, MIDDLEBURG, FL 32068-8407
(904) 755-2367
Mailing address
PO BOX 331, MIDDLEBURG, FL 32050-0331
(904) 755-2367
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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