Healthcare Provider Details

I. General information

NPI: 1023325610
Provider Name (Legal Business Name): DELROSE MEDICAL EQUIPMENT & SUPPLY,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S CENTRAL EXPY SUITE 541
RICHARDSON TX
75080-7415
US

IV. Provider business mailing address

811 S CENTRAL EXPY SUITE 541
RICHARDSON TX
75080-7415
US

V. Phone/Fax

Practice location:
  • Phone: 972-699-9200
  • Fax: 972-699-9207
Mailing address:
  • Phone: 972-699-9200
  • Fax: 972-699-9207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number217057303
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number217057301
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number217057302
License Number StateTX

VIII. Authorized Official

Name: IGNA IKE UGOH
Title or Position: DIRECTOR
Credential: RRT,RCP
Phone: 972-699-9200