Certified Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

604-000-651 Issued in WA

Legal business name

CERTIFIED MEDICAL SUPPLY, INC.

Practice address

603 E 8TH St Ste a
Port Angeles, WA 98362-6251

Phone

(360) 406-5063

Fax

(360) 477-4283

NPI assigned

Jun 21, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Gibbs

Title

President

Phone

(702) 793-9763

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1205286168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "address_2": "SUITE D651",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "702-851-5610",
            "fax_number": "702-943-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E 8TH ST STE A",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626251",
            "telephone_number": "360-406-5063",
            "fax_number": "360-477-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-793-9763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "604-000-651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Celestino, LMHC
• Timothy Alan Cella
• Center for Bone & Joint Surgery LTD
• Maxine Ceraolo, ARNP
• Certified Hearing Inc.
• Karla Chamberlin
• Darrell Ray Chambers, CDPT
• David Lane Chance, D.D.S.
• Leonard M Chance Jr., D.D.S.
• Matthew Ryan Chance, ARNP

• Durable Medical Equipment & Medical Supplies in Port Angeles, WA
• Providers in Port Angeles, 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 Aug 17, 2018; 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.