Blue Mountain Medical Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

LR00000073 Issued in WA

Legal business name

BLUE MOUNTAIN MEDICAL INC

Practice address

1530 S Union Ave
Suite 10
Tacoma, WA 98405-1954

Phone

(253) 759-2700

Fax

(253) 759-9986

NPI assigned

May 30, 2008

Organization subpart

No

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 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1487812012",
    "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": "1530 S UNION AVE",
            "address_2": "SUITE 10",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051954",
            "telephone_number": "253-759-2700",
            "fax_number": "253-759-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-06-19",
        "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": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WA",
            "license": "LR00000073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "995195",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Oxygen Equipment & Supplies (DME) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.