Paul E. Gervais

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAUL E. GERVAIS

Doing business as

Medical Supply of Central Oregon

Practice address

356 SW 6TH St
Redmond, OR 97756-2201

Phone

(541) 504-7700

Fax

(541) 504-9170

NPI assigned

Sep 25, 2006

Last updated

Aug 22, 2020By 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. Paul E Gervais

Title

Owner

Phone

(541) 504-7700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medical Supply of Central Oregon Doing business as

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770683880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 SW 6TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562201",
            "telephone_number": "541-504-7700",
            "fax_number": "541-504-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 SW 6TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562201",
            "telephone_number": "541-504-7700",
            "fax_number": "541-504-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL E. GERVAIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERVAIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-504-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269868",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COIHS",
            "identifier": "68560",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Supply of Central Oregon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Taylor Patti
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• John J Pavlicek, DMD
• Matthew John Pavlovich, DDS
• Peaks and Pines Counseling LLC
• Renee C Peck, QMHA-R

• Durable Medical Equipment & Medical Supplies in Redmond, OR
• Providers in Redmond, 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 Aug 22, 2020; 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.