Old Cannery Furniture Warehouse LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OLD CANNERY FURNITURE WAREHOUSE LLC

Doing business as

The Old Cannery

Practice address

13608 Valley Ave E
Sumner, WA 98390-1535

Phone

(253) 863-0422

Fax

(253) 863-5641

NPI assigned

Apr 30, 2014

Last updated

Apr 30, 2014By 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. David C Radcliffe

Title

Company C.E.O.

Phone

(253) 863-0422

Specialties & licenses 1

Addresses

Other names 1

• The Old Cannery Doing business as

Locations

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1396155370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13608 VALLEY AVE E",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901535",
            "telephone_number": "253-863-0422",
            "fax_number": "253-863-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13608 VALLEY AVE E",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901535",
            "telephone_number": "253-863-0422",
            "fax_number": "253-863-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD CANNERY FURNITURE WAREHOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "RADCLIFFE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COMPANY C.E.O.",
        "authorized_official_telephone_number": "253-863-0422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Old Cannery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholsons Sumner Pharmacy Inc (Sumner Pharmacy)
• Christopher John Nielsen, D.M.D
• Nikolina Petrasevic Nielsen, DMD
• Melissa Marie Noren, LMT
• Kelsey Marie O'Brien, PT, DPT
• Brandi M Olsen, LMP
• Nolan Shawn Omalley, DPT
• Mikayla Marie Orphan, MS, RD, LD
• Pacesetters Medical Equipment
• Marylee S Packer, LMFT

• Durable Medical Equipment & Medical Supplies in Sumner, WA
• Providers in Sumner, 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 Apr 30, 2014; 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.