PACIFIC COAST MEDICAL SUPPLY, INC (NPI# 1952580953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952580953 |
| Entity Type | Organization |
| Organization Name | PACIFIC COAST MEDICAL SUPPLY, INC |
| Practice Address |
8080 E Mill Plain Blvd Vancouver WA 98664-2002 |
| Mailing Address |
Po Box 634 Astoria OR 97103-0634 |
| Practice Telephone | 3606955161 |
| Practice Fax Number | 3606952257 |
| Mailing Telephone | 3606955161 |
| Mailing Fax Number | 3606952257 |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |
| Authorized Official Name | MR. NORMAN DUANE STUTZNEGGER JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 5033380349 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
WA | Suppliers | |
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9046947 | 05 | |
| OR | 158971 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC COAST MEDICAL SUPPLY, INC. | 2158 Exchange St Ste 106, Astoria, OR 97103 |
| Street Address |
8080 E MILL PLAIN BLVD |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98664-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285249938 | Angelica Maria Parle-fresquez | Speech-Language Pathologist | Early Childhood Assessment Center - Lieser School, 301 S. Lieser Rd, Vancouver, WA 98664 | 2020-09-10 |
| 1467923441 | Elizabeth Steen | Counselor | 230 E. State St., Mossyrock, WA 98664 | 2018-12-17 |
| 1497241657 | Chelsey Nicole Parker | Peer Specialist | 9815 Ne 3rd St, Vancouver, WA 98664 | 2018-07-10 |
| 1881145431 | Brent Homan | Occupational Therapist | 807 Se Morgan Rd., Vancouver, WA 98664 | 2016-10-19 |
| 1114474277 | Rebecca Marie Stefan | Nurse's Aide | 10025 Ne 19th St, Vancouver, WA 98664 | 2016-09-07 |
| 1528454105 | Alicia Ford | Dietitian, Registered | 700 Ne 87th Ave Ste 280, Vancouver, WA 98664 | 2015-04-10 |
| 1033504261 | Reid Roberts Bennett | Anesthesiology | 505 Ne 87th Ave Ste 210, Vancouver, WA 98664 | 2015-04-03 |
| 1235550856 | Nikolay Nikolaevich Chernukhin Jr. | Chiropractor | 221-a Ne 104th Ave, Suite 205, Vancouver, WA 98664 | 2013-12-27 |
| 1013278712 | Serena Harker | Physical Therapy Assistant | 221a Ne 104th Ave, Suite #205, Vancouver, WA 98664 | 2012-05-30 |
| 1295091080 | Rebeca C Johnson | Massage Therapist | 11015 Ne 4th Plain Suite B, Vancouver, WA 98664 | 2012-04-05 |
| Find all providers in zip 98664 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790882496 | Rkso LLC | Durable Medical Equipment & Medical Supplies | 416 Ne 87th Ave Ste 2, Vancouver, WA 98664-1930 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356955249 | Olympia Respiratory Services LLC | Durable Medical Equipment & Medical Supplies | 333 Fair St, Centralia, WA 98531-8906 | 2020-09-08 |
| 1831715739 | Yangchen Inc | Durable Medical Equipment & Medical Supplies | 9215 151st Ave Ne, Redmond, WA 98052-3511 | 2020-06-17 |
| 1023648425 | Performance Modalities Inc | Durable Medical Equipment & Medical Supplies | 230 S 15th St Ste B, Mount Vernon, WA 98274-4570 | 2020-01-24 |
| 1316591217 | Martin Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8079 E Main Street, Suite 101, Port Orchard, WA 98366 | 2019-07-29 |
| 1457810822 | Sleep Orbit | Durable Medical Equipment & Medical Supplies | 16201 E Indiana Ave Ste 1111, Spokane Valley, WA 99216-2838 | 2019-03-15 |
| 1588196794 | Arris Health Services LLC | Durable Medical Equipment & Medical Supplies | 4002 Tacoma Mall Blvd, Suite 204, Tacoma, WA 98409-7702 | 2017-03-28 |
| 1720523103 | Pinnacle Healthcare Center, Pllc | Durable Medical Equipment & Medical Supplies | 2309 W. Dolarway Rd, Ste. 2, Ellensburg, WA 98926-8087 | 2016-12-21 |
| 1629444047 | Sound Oxygen Service LLC | Durable Medical Equipment & Medical Supplies | 18905 33rd Ave W Ste 111, Lynnwood, WA 98036-4716 | 2015-08-19 |
| 1407231988 | Valuplus Home Health Care Center, Inc | Durable Medical Equipment & Medical Supplies | 1737 N Wenatchee Ave, Suite D, Wenatchee, WA 98801-1189 | 2015-07-24 |
| 1720496912 | Olympia Respiratory Services LLC | Durable Medical Equipment & Medical Supplies | 954 Anderson Dr Ste 109, Aberdeen, WA 98520-1001 | 2014-07-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.