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General NPI Number Information
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NPI Number | 1821296690
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Entity Type | Organization
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Legal Business Name | LDELANE LLC
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 4905 N NAVARRO ST SUITE B
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City | VICTORIA
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State | TX
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Zip | 77904-2022
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Country | US
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Telephone | 361-580-1112
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Fax | 361-580-1114
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Provider Business Mailing Address
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Address Line | 4905 N NAVARRO ST SUITE B
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City | VICTORIA
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State | TX
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Zip | 77904-2022
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Country | US
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Telephone | 361-580-1112
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Fax | 361-580-1114
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Authorized Official
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Title or Position | PRES.
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Name | MRS. LINDA KAY PALMER
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Credential |
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Telephone | 361-580-1112
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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 | 0098004
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License Number State | TX
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