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General NPI Number Information
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NPI Number | 1588316269
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Entity Type | Organization
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Legal Business Name | GODSPEED DME, LLC
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 03/19/2023
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Provider Practice Location Address
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Address Line | 1503 S MARGARET AVE UNIT 1 & 2
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City | KIRBYVILLE
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State | TX
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Zip | 75956-2615
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Country | US
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Telephone | 409-791-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 205 GREENTREE ST
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City | LUMBERTON
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State | TX
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Zip | 77657-5903
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Country | US
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Telephone | 409-791-0087
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. NAKALA RANELLE DELARUE
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Credential | RCP
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Telephone | 409-791-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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