MEDICARE: D.P.S ENERGY LLC

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1760348825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D.P.S ENERGY LLC

Provider Business Mailing Address
First Line	:	150 W BRAMBLETON AVE APT 512
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2056
Country	:	US
Telephone Number	:	864-346-4488
Fax Number	:	713-766-2821

Provider Business Practice Location Address
First Line	:	150 W BRAMBLETON AVE APT 512
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2056
Country	:	US
Telephone Number	:	864-346-4488
Fax Number	:	713-766-2821

Authorized Official
Title or Position	:	OWNER
Name	:	HOWARD RHETT
Credential	:
Telephone Number	:	864-346-4488

Provider Enumeration Date	:	01/01/2026
Last Update Date	:	01/01/2026

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