NPIMap

Organization Active NPI

Copper Creek Medical, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Tacoma, WA
National Provider Identifier
1700145869
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
COPPER CREEK MEDICAL, INC.
Practice address
1818 S Union Ave
Suite 2B
Tacoma, WA 98405-1953
Phone
(253) 759-2700
Fax
(253) 759-9986
NPI assigned
May 10, 2012
Last updated
Oct 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Alfred A Tall, RRT, RPSGT
Title
President
Phone
(509) 998-4309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

1818 S Union Ave
Suite 2B
Tacoma, WA 98405-1953

Mailing address

1512 N Vercler Rd
Suite 1
Spokane Valley, WA 99216-1087
Phone (509) 465-5522

National Provider Directory

National Provider Directory
Tax ID family
Copper Creek Medical Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1512 N Vercler Rd
Ste 1
Spokane Valley, WA 99216
Phone (509) 465-5522

NPI Registry JSON

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1700145869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 N VERCLER RD",
            "address_2": "SUITE 1",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161087",
            "telephone_number": "509-465-5522",
            "fax_number": "509-465-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 S UNION AVE",
            "address_2": "SUITE 2B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051953",
            "telephone_number": "253-759-2700",
            "fax_number": "253-759-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER CREEK MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "TALL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-998-4309",
        "authorized_official_credential": "RRT, RPSGT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 12, 2012; 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.