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Organization
GOOSE LAKE MEDICAL SERVICES INC
Active
Organization
GOOSE LAKE MEDICAL SERVICES INC
Active
Other names
Lake Health Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON DYBDAL (CEO/AUTHORIZED OFFICIAL)
(541) 947-7307
Entity
Organization
Contact information
Practice address
220 N E ST, LAKEVIEW, OR 97630-1407
(541) 947-2370
(541) 947-0929
Mailing address
220 N E ST, LAKEVIEW, OR 97630-1407
(541) 947-2114
(541) 947-2433
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
NULL
Other
Enumeration date
03/07/2016
Last updated
12/18/2025
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