Provider Demographics
NPI:1265227607
Name:DIVINE MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:DIVINE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:LERMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-635-0966
Mailing Address - Street 1:3922 RASOUL DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-4503
Mailing Address - Country:US
Mailing Address - Phone:956-635-0966
Mailing Address - Fax:
Practice Address - Street 1:10962 ROOM FOR MORE WAY STE M01
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-2262
Practice Address - Country:US
Practice Address - Phone:956-635-0966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies