Sandcreek Medical Sales & Rentals

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

DME139 Issued in ID

Legal business name

SANDCREEK MEDICAL SALES & RENTALS

Doing business as

Sandcreek Medical

Practice address

306 1/2 N 1St Ave
Sandpoint, ID 83864-1404

Phone

(208) 263-3713

Fax

(208) 263-9133

NPI assigned

Jul 4, 2006

Last updated

Dec 4, 2012By 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

Gary Daniel Rench

Title

President

Phone

(208) 263-3713

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SANDCREEK MEDICAL Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1114957008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 974",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640853",
            "telephone_number": "208-263-3713",
            "fax_number": "208-263-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 1/2 N 1ST AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641404",
            "telephone_number": "208-263-3713",
            "fax_number": "208-263-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDCREEK MEDICAL SALES & RENTALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "RENCH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-263-3713"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": "DME139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002650500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANDCREEK MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Edward Rust Jr., M.D.
• Kimberly Amelia Rutland, WHNP
• Safeway Inc (Safeway Pharmacy #0350)
• Josie Saganski, DC
• Sand Creek Mental Health and Wellness
• Lori Sanders, LMFT
• Sandpoint Anesthesia Associates PLLC
• Sandpoint Drug Inc
• Sandpoint Family Health Center (Family Health Center)
• Sandpoint Family Health Center, PLLC

• Oxygen Equipment & Supplies (DME) in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Oxygen Equipment & Supplies (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.