Healthcare Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

653593 Issued in OR

Legal business name

HEALTHCARE MEDICAL SUPPLY

Practice address

4000 SE 82ND Ave
Suite 1500
Portland, OR 97266-2924

Phone

(503) 772-5333

Fax

(503) 772-5366

NPI assigned

Dec 23, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Pavel FokshaNPI 1396871083

Title

President

Phone

(503) 772-5333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pavel Foksha

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1396871083
  NPD (past) Authorized official

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1396014064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SE 82ND AVE",
            "address_2": "SUITE 1500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97266",
            "telephone_number": "503-772-5333",
            "fax_number": "503-772-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SE 82ND AVE",
            "address_2": "SUITE 1500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662924",
            "telephone_number": "503-772-5333",
            "fax_number": "503-772-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "FOKSHA",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-772-5333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "653593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274628",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Healthcore Psychiatry Consultants PLLC
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• Healthmark Inc
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• Durable Medical Equipment & Medical Supplies in Portland, OR
• Providers in Portland, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.