Geneva Woods Health Supplies PNW, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

604-124-465-001-0003 Issued in WA

Legal business name

GENEVA WOODS HEALTH SUPPLIES PNW, LLC

Doing business as

MyMedSupplies

Practice address

6326 E Trent Ave Ste a
Spokane Valley, WA 99212-1220

Phone

(509) 867-3466

Fax

(866) 583-9296

NPI assigned

Mar 24, 2015

Last updated

Sep 9, 2021By 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

Dan Afrasiabi

Title

President/Authorized Official

Phone

(888) 441-1312

Specialties & licenses 2

Addresses

Other identifiers 8

Other names 1

• MyMedSupplies Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Geneva Woods Health Supplies PNW, LLC

  dba MyMedSupplies

  • Durable Medical Equipment & Medical Supplies
  • Lacey, WA
  • NPI 1942339015

  6709143936

  Same PAC ID

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

Tax ID family

Geneva Woods Health Supplies PNW LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Geneva Woods Health Supplies PNW, LLC

  dba MyMedSupplies

  • Durable Medical Equipment & Medical Supplies
  • Lacey, WA
  • NPI 1942339015
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc

  dba CVS Pharmacy # 05874

  • Pharmacy
  • Boston, MA
  • NPI 1821197120

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Peaks and Plains Medical, Inc.

  dba MyMedSupplies

  • Durable Medical Equipment & Medical Supplies
  • Spokane Valley, WA
  • NPI 1487608949

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1174917579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94347",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246647",
            "telephone_number": "509-588-7241",
            "fax_number": "866-583-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 E TRENT AVE STE A",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992121220",
            "telephone_number": "509-867-3466",
            "fax_number": "866-583-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA WOODS HEALTH SUPPLIES PNW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "AFRASIABI",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "888-441-1312"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "604-124-465-001-0003",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WA",
            "license": "604-124-465-001-0003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0226655",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038339970001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47576758",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500736763",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082809",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174917579",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174917579",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2092020",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyMedSupplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dina Gebretatios
• Michelle Geer
• Dawnell Marie Geller
• Dillan J Gemmell
• Genesis Rehab Services
• Steffie Genevieve, MSW, LICSW, CDP, SAP
• Gabrielle J Genovesi, RN
• Genuine Gentle Care LLC
• George J Velis, D.D.S., P.S.
• George J. Bourekis, D.D.S., P.S.

• Durable Medical Equipment & Medical Supplies in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.