Pacific Coast Medical Supply, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

PACIFIC COAST MEDICAL SUPPLY, INC

Practice address

8080 E Mill Plain Blvd
Vancouver, WA 98664-2002

Phone

(360) 695-5161

Fax

(360) 695-2257

NPI assigned

Oct 26, 2007

Last updated

Oct 26, 2007By 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. Norman Duane Stutznegger Jr.

Title

President/Ceo

Phone

(503) 338-0349

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1952580953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971030634",
            "telephone_number": "360-695-5161",
            "fax_number": "360-695-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642002",
            "telephone_number": "360-695-5161",
            "fax_number": "360-695-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "STUTZNEGGER",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "503-338-0349",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158971",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9046947",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pacific Dermatology P.C.
• Pacific Eye Group
• Pacific Eye Group, PC (Pacific Eye Group)
• Pacific Gastro Health PLLC

• Oxygen Equipment & Supplies (DME) in Vancouver, WA
• Providers in Vancouver, 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 Oct 26, 2007; 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.