Organization
DIVINE MEDICAL EQUIPMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANAYO ONYECHI (CHIEF FINANCIAL OFFICER)
(214) 221-0746
Entity
Organization
Contact information
Practice address
11311 AUDELIA RD APT 110, DALLAS, TX 75243-7331
(214) 221-0746
(214) 221-0749
Mailing address
11311 AUDELIA RD APT 110, DALLAS, TX 75243-7331
(214) 221-0746
(214) 221-0749
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0080696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080696
STATE LICENSE
TX
Enumeration date
02/21/2007
Last updated
08/22/2020
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