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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