# DEEPBLUE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801433446
- **Authorized official:** MUHAMMAD BILAL KHAN (CHIEF OPERATIONS OFFICER)
- **Authorized official phone:** (209) 561-3219

## Contact information

- **Practice address:** 1101 S CRESCENT AVE, LODI, CA 95240-5601
- **Practice address phone:** (209) 561-3219
- **Mailing address:** 1101 S CRESCENT AVE, LODI, CA 95240-5601
- **Mailing address phone:** (209) 561-3219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/03/2019
- **Last updated:** 07/13/2021