Emmanuel Medical Supply Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EMMANUEL MEDICAL SUPPLY CO

Practice address

31260 Pacific Hwy S
Ste 8
Federal Way, WA 98003-5448

Phone

(253) 529-2364

Fax

(253) 529-2364

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Haesung Park

Title

Owner

Phone

(253) 529-2364

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1821162355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31260 PACIFIC HWY S",
            "address_2": "STE 8",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035448",
            "telephone_number": "253-529-2364",
            "fax_number": "253-529-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31260 PACIFIC HWY S",
            "address_2": "STE 8",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035448",
            "telephone_number": "253-529-2364",
            "fax_number": "253-529-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HAESUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-529-2364"
    },
    "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": "6009914",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Curtis S Endow, MD
• Raphael Enrico
• Karl W Entenmann, CPO
• Envision Hospice of Washington LLC

• Durable Medical Equipment & Medical Supplies in Federal Way, WA
• Providers in Federal Way, 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 May 1, 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.