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NPI 1265940258

NPI 1265940258 : GOULD'S DISCOUNT MEDICAL LLC : BOWLING GREEN, KY

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General NPI Number Information
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    NPI Number           |    1265940258
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOULD'S DISCOUNT MEDICAL LLC 
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Dates
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    Enumeration Date     |    01/12/2018
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    1051 BRYANT WAY STE 207 
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    City                 |    BOWLING GREEN
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    State                |    KY
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    Zip                  |    42103-7116
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    Country              |    US
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    Telephone            |    270-297-8801
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    Fax                  |    270-387-1818
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Provider Business Mailing Address
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    Address Line         |    555 E NORTH LN STE 5075 
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    City                 |    CONSHOHOCKEN
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    State                |    PA
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    Zip                  |    19428-2233
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    Country              |    US
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    Telephone            |    610-424-4515
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF COMPLIANCE OFFICER
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    Name                 |     WENDY  RUSSALESI 
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    Credential           |    
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    Telephone            |    484-246-9499
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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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Taxonomy #2
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    Taxonomy Code        |    332BC3200X
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    Taxonomy Name        |    Customized Equipment (DME)
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    332BP3500X
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    Taxonomy Name        |    Parenteral & Enteral Nutrition Supplies (DME)
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    332BX2000X
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    Taxonomy Name        |    Oxygen Equipment & Supplies (DME)
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    License Number       |    
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    License Number State |    
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