Organization
HOME DELIVERY INCONTINENT SUPPLIES CO INC
Active
Other names
HDIS
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD GOODWIN (PRESIDENT)
(314) 997-8771
Entity
Organization
Contact information
Practice address
9385 DIELMAN INDUSTRIAL DR, OLIVETTE, MO 63132-2214
(314) 997-8771
(888) 874-4347
Mailing address
9385 DIELMAN INDUSTRIAL DR, OLIVETTE, MO 63132-2214
(314) 997-8771
(888) 874-4347
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
B0077345A
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010070724
—
VA
05
—
015365201
—
TX
05
—
02056215
—
NY
05
—
0543678
—
IA
05
—
100013540A
—
IN
05
—
117002300
—
MD
05
—
118720716
—
AR
05
—
1559334
—
LA
05
—
2167408
—
OH
05
—
535063800
—
MN
05
—
628652307
—
MO
05
—
81866300
—
WI
05
—
8358702
—
NJ
05
—
9028242
—
WA
05
—
98013006
—
CO
Enumeration date
10/03/2007
Last updated
04/23/2025
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