# GOOSE LAKE MEDICAL SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Health Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952761710
- **Authorized official:** LANDON DYBDAL (CEO/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (541) 947-7307

## Contact information

- **Practice address:** 220 N E ST, LAKEVIEW, OR 97630-1407
- **Practice address phone:** (541) 947-2370
- **Practice address fax:** (541) 947-0929
- **Mailing address:** 220 N E ST, LAKEVIEW, OR 97630-1407
- **Mailing address phone:** (541) 947-2114
- **Mailing address fax:** (541) 947-2433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2016
- **Last updated:** 12/18/2025