NPIMap

Organization Active NPI

Blue Mountain Medical Inc

  • Durable Medical Equipment & Medical Supplies
  • Puyallup, WA
National Provider Identifier
1285870451
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
LR00000073 Issued in WA
Legal business name
BLUE MOUNTAIN MEDICAL INC
Practice address
16515 Meridian E
Suite 203 B
Puyallup, WA 98375-6251
Phone
(253) 841-2700
NPI assigned
Dec 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Authorized official

Name
Mr. Alfred Anthony Tall, RRT, RPSGT
Title
President
Phone
(425) 673-3774

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X LR00000073 WA Primary
Oxygen Equipment & Supplies (DME) 332BX2000X LR00000073 WA

Addresses

Primary practice location

16515 Meridian E
Suite 203 B
Puyallup, WA 98375-6251

Mailing address

7320 216TH St SW
Suite #30
Edmonds, WA 98026-8006
Phone (425) 673-3773

Other identifiers 1

IdentifierTypeStateIssuer
995195MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Blue Mountain Medical Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1285870451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW",
            "address_2": "SUITE #30",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3773",
            "fax_number": "425-673-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 MERIDIAN E",
            "address_2": "SUITE 203 B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756251",
            "telephone_number": "253-841-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "TALL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-673-3774",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT, RPSGT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "LR00000073",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WA",
            "license": "LR00000073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "995195",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.