Organization Active NPI

Diamond Home Care Agency LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1861200875
Registry record updated Dec 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
DIAMOND HOME CARE AGENCY LLC
Practice address
12900 Medford Rd
Philadelphia, PA 19154-2013
Phone
(215) 651-2413
NPI assigned
Dec 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mirna Medina
Title
Administrator
Phone
(215) 651-2413

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

12900 Medford Rd
Philadelphia, PA 19154-2013

Mailing address

12900 Medford Rd
Philadelphia, PA 19154-2013
Phone (215) 651-2413

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734739200000",
    "number": "1861200875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 MEDFORD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191542013",
            "telephone_number": "215-651-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 MEDFORD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191542013",
            "telephone_number": "215-651-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND HOME CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-21",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "MIRNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-651-2413"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.