Avamere Medical Supply LLC
Organization Active NPI Nursing Facility Supplies (DME) · Wilsonville, OR
NPI 1104829258 · NPPES record last updated Jan 21, 2010
Key facts
- NPI
- 1104829258
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility Supplies (DME) 332BN1400X
- Legal business name
- AVAMERE MEDICAL SUPPLY LLC
- Practice address
- 25117 SW Parkway Ave
Ste F
Wilsonville, OR 97070-9697 - Phone
- (503) 783-2483
- Fax
- (503) 783-2480
- NPI assigned
- May 23, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Richard A. Dillon
- Title
- Owner/Coo
- Phone
- (971) 224-2819
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility Supplies (DME) | 332BN1400X | Yes | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X |
Addresses
Primary practice location
25117 SW Parkway Ave
Ste F
Wilsonville, OR 97070-9697
Mailing address
25117 SW Parkway Ave
Ste F
Wilsonville, OR 97070-9697
Phone (503) 783-2483
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230869 | Medicaid | OR | |
| 9052515 | Medicaid | WA | |
| MS001OR | Medicaid | AK |
Other names
- Signature Medical Supply
Other providers in Wilsonville, OR
- Anne Pernichele DC PC
- Analyne A Antonio-Craig
- Assist Services
- James Homer Atkins III
- Sarah Marie Atkins
- Avamere Outpatient Services LLC
- Adonna Avon
- Robin Lynette Badger
- Kathryn Marie Bailey
- Jason Aaron Bajuscak
All providers in Wilsonville, OR · Nursing Facility Supplies (DME) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.