Avamere Medical Supply LLC

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

AVAMERE MEDICAL SUPPLY LLC

Doing business as

Signature Medical Supply

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

Last updated

Jan 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard A. Dillon

Title

Owner/Coo

Phone

(971) 224-2819

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Signature Medical Supply Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1104829258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "STE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "503-783-2483",
            "fax_number": "503-783-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "STE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "503-783-2483",
            "fax_number": "503-783-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAMERE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/COO",
        "authorized_official_telephone_number": "971-224-2819",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS001OR",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230869",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9052515",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Pernichele DC PC (Art of Wellness Family Chiropractic Center)
• Analyne A Antonio-Craig, PT
• Assist Services
• James Homer Atkins III, B.A.
• Sarah Marie Atkins, PTA
• Avamere Outpatient Services LLC (Merit Rehab)
• Adonna Avon
• Robin Lynette Badger, PT
• Kathryn Marie Bailey, OTR/L
• Jason Aaron Bajuscak, D.M.D.

• Nursing Facility Supplies (DME) in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Nursing Facility Supplies (DME) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.