Organization
HEPHZIBAH-BEULAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUWATAYO G ODEYEMI (REGISTERED NURSE)
(940) 231-6643
Entity
Organization
Contact information
Practice address
14249 LAKE LODGE DR, CONROE, TX 77384-1539
(940) 231-6643
Mailing address
14249 LAKE LODGE DR, CONROE, TX 77384-1539
(940) 231-6643
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
03/31/2026
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