Active NPI
Home Delivery Incontinent Supplies Co Inc
- Durable Medical Equipment & Medical Supplies
- Olivette, MO
National Provider Identifier
1841487980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- B0077345A
- Legal business name
- HOME DELIVERY INCONTINENT SUPPLIES CO INC
- Practice address
- 9385 Dielman Industrial Dr
Olivette, MO 63132-2214 - Phone
- (314) 997-8771
- Fax
- (888) 874-4347
- NPI assigned
- Oct 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brad Goodwin
- Title
- President
- Phone
- (314) 997-8771
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | B0077345A | MO | Primary |
Addresses
Primary practice location
9385 Dielman Industrial Dr
Olivette, MO 63132-2214
Mailing address
9385 Dielman Industrial Dr
Olivette, MO 63132-2214
Phone (314) 997-8771
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02056215 | Medicaid | NY | |
| 1559334 | Medicaid | LA | |
| 0543678 | Medicaid | IA | |
| 81866300 | Medicaid | WI | |
| 9028242 | Medicaid | WA | |
| 98013006 | Medicaid | CO | |
| 010070724 | Medicaid | VA | |
| 015365201 | Medicaid | TX | |
| 628652307 | Medicaid | MO | |
| 8358702 | Medicaid | NJ | |
| 100013540A | Medicaid | IN | |
| 118720716 | Medicaid | AR | |
| 2167408 | Medicaid | OH | |
| 117002300 | Medicaid | MD | |
| 535063800 | Medicaid | MN |
Other names 1
- HDIS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930077912 | MO | DME Supplier - Medical Supply Company | 5193844439 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Olivette, MO |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Durable Medical Equipment & Medical Supplies
- Olivette, MO
- NPI 1649383084
O20100930077912
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745366400000",
"number": "1841487980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9385 DIELMAN INDUSTRIAL DR",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631322214",
"telephone_number": "314-997-8771",
"fax_number": "888-874-4347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9385 DIELMAN INDUSTRIAL DR",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631322214",
"telephone_number": "314-997-8771",
"fax_number": "888-874-4347"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOME DELIVERY INCONTINENT SUPPLIES CO INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-03",
"last_updated": "2025-04-23",
"certification_date": "2025-04-23",
"status": "A",
"authorized_official_last_name": "GOODWIN",
"authorized_official_first_name": "BRAD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "314-997-8771"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MO",
"license": "B0077345A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02056215",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1559334",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0543678",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81866300",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9028242",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "98013006",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010070724",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "015365201",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "628652307",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8358702",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100013540A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118720716",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2167408",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117002300",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "535063800",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HDIS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Olivette, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.