MEDICARE: GOLDEN HEART MEDICAL SUPPLIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1124995089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HEART MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	2111 SAM BASS RD STE 500A
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-1801
Country	:	US
Telephone Number	:	512-879-4155
Fax Number	:	512-788-9585

Provider Business Practice Location Address
First Line	:	2111 SAM BASS RD STE 500A
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-1801
Country	:	US
Telephone Number	:	512-879-4155
Fax Number	:	512-788-9585

Authorized Official
Title or Position	:	OWNER
Name	:	CATHARINE OOSTDAM
Credential	:
Telephone Number	:	512-879-4155

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	04/27/2026

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