Active NPI
Sound Health Medical Supply
- Customized Equipment (DME)
- Tacoma, WA
National Provider Identifier
1275703084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- Legal business name
- SOUND HEALTH MEDICAL SUPPLY
- Practice address
- 2811 S 12TH St
Tacoma, WA 98405-2746 - Phone
- (253) 274-5000
- Fax
- (253) 572-3111
- NPI assigned
- Mar 7, 2008
- Last updated
- Nov 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Courtney Amanda Tebbs
- Title
- President
- Phone
- (253) 225-6770
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | NU | Primary |
Addresses
Primary practice location
2811 S 12TH St
Tacoma, WA 98405-2746
Mailing address
2811 S 12TH St
Tacoma, WA 98405-2746
Phone (253) 274-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9062738 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930048230 | WA | DME Supplier - Medical Supply Company | 0042410789 | Practice locations: Tacoma, WA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Durable Medical Equipment & Medical Supplies
- Tigard, OR
- NPI 1215262738
0042410789
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320278400000",
"number": "1275703084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2811 S 12TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052746",
"telephone_number": "253-274-5000",
"fax_number": "253-572-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 S 12TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052746",
"telephone_number": "253-274-5000",
"fax_number": "253-572-3111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUND HEALTH MEDICAL SUPPLY",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-07",
"last_updated": "2011-11-03",
"status": "A",
"authorized_official_last_name": "TEBBS",
"authorized_official_first_name": "COURTNEY",
"authorized_official_middle_name": "AMANDA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "253-225-6770"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9062738",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.