Organization
DIAMOND ONE HEALTHCARE
Active
Organization
DIAMOND ONE HEALTHCARE
Active
Other names
home healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARD REYNOLDS JR. ULITMATE MEDICAL ACA (CEO)
(901) 362-6015
Entity
Organization
Contact information
Practice address
3514 CLEARBROOK ST, MEMPHIS, TN 38118-5547
(901) 362-6015
(901) 405-5106
Mailing address
3514 CLEARBROOK ST, MEMPHIS, TN 38118-5547
(901) 362-6015
(901) 405-5106
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
113004427
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113004427
—
TN
Enumeration date
10/29/2013
Last updated
10/29/2013
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