Geneva Woods Health Supplies PNW, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

604-124-465 Issued in WA

Legal business name

GENEVA WOODS HEALTH SUPPLIES PNW, LLC

Doing business as

MyMedSupplies

Practice address

6149 Martin Way E
Lacey, WA 98516-5547

Phone

(360) 456-5475

Fax

(360) 456-5182

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Dan Afrasiabi

Title

President/Authorized Official

Phone

(888) 441-1312

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• MyMedSupplies Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Geneva Woods Health Supplies PNW, LLC

  dba MyMedSupplies

  • Durable Medical Equipment & Medical Supplies
  • Spokane Valley, WA
  • NPI 1174917579

  6709143936

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Geneva Woods Health Supplies PNW LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Geneva Woods Health Supplies PNW, LLC

  dba MyMedSupplies

  • Durable Medical Equipment & Medical Supplies
  • Spokane Valley, WA
  • NPI 1174917579
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc

  dba CVS Pharmacy #07413

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul McCarty, PHARMD

  • Geriatric Pharmacist
  • Olympia, WA
  • NPI 1730384918
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1942339015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94347",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246647",
            "telephone_number": "509-588-7241",
            "fax_number": "866-583-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6149 MARTIN WAY E",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165547",
            "telephone_number": "360-456-5475",
            "fax_number": "360-456-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA WOODS HEALTH SUPPLIES PNW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "AFRASIABI",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "888-441-1312"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "604-124-465",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WA",
            "license": "604-124-465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942339015",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500736762",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2092007",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyMedSupplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Self Gautreaux, MSW, LICSWA
• April Rose Gaydos, LMP
• Ellen Geary, MS
• Douglas Gemmell
• Generations Midwifery Services, LLC
• Yan Geng, MD
• Florence Genovia, OTR
• William Georgeson
• Jane M. Geraci, M.D., MPH
• Seth C Gerken

• Durable Medical Equipment & Medical Supplies in Lacey, WA
• Providers in Lacey, 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 Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.