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General NPI Number Information
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NPI Number | 1497850879
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Entity Type | Organization
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Legal Business Name | HOME DELIVERY INCONTINENT SUPPLIES CO INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 9385 DIELMAN INDUSTRIAL DRIVE
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City | OLIVETTE
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State | MO
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Zip | 63132-2214
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Country | US
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Telephone | 800-933-0822
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Fax | 888-874-4347
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Provider Business Mailing Address
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Address Line | 9385 DIELMAN INDUSTRIAL DRIVE
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City | OLIVETTE
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State | MO
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Zip | 63132-2214
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Country | US
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Telephone | 800-933-0822
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Fax | 888-874-4347
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRAD GOODWIN
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Credential |
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Telephone | 314-997-8771
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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 | B0077345A
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License Number State | MO
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