Convalescent Equipment & Supply Co. Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

600561377 Issued in WA

Legal business name

CONVALESCENT EQUIPMENT & SUPPLY CO. INC.

Practice address

21829 Highway 99
Edmonds, WA 98026-8035

Phone

(425) 774-0083

Fax

(425) 774-0420

NPI assigned

Sep 20, 2006

Last updated

May 4, 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

Mr. Mike Cordova

Title

President

Phone

(425) 774-0083

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Convalescent Equipment and Supply Co. Inc.

  • Durable Medical Equipment & Medical Supplies
  • Vancouver, WA
  • NPI 1710303169
  NPPES parent name

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1194822213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21829 HIGHWAY 99",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268035",
            "telephone_number": "425-774-0083",
            "fax_number": "425-774-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21829 HIGHWAY 99",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268035",
            "telephone_number": "425-774-0083",
            "fax_number": "425-774-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVALESCENT EQUIPMENT & SUPPLY CO. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-774-0083",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "600561377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006958",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jessica Corbeille, ND
• Tami J Corbett, ARNP

• Durable Medical Equipment & Medical Supplies in Edmonds, WA
• Providers in Edmonds, 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 May 4, 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.