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General NPI Number Information
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NPI Number | 1265227607
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Entity Type | Organization
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Legal Business Name | DIVINE MEDICAL EQUIPMENT, LLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 10962 ROOM FOR MORE WAY STE M01
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City | LAREDO
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State | TX
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Zip | 78045-2262
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Country | US
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Telephone | 956-635-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 3922 RASOUL DR
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City | LAREDO
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State | TX
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Zip | 78045-4503
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Country | US
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Telephone | 956-635-0966
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER RAFAEL LERMA
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Credential |
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Telephone | 956-635-0966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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