1154455830 NPI number — AARO MEDICAL SUPPLIES INC

Table of content: (NPI 1154455830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154455830 NPI number — AARO MEDICAL SUPPLIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AARO MEDICAL SUPPLIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154455830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2222 SIMPSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABERDEEN
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98520-3514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-532-2222
Provider Business Mailing Address Fax Number:
360-533-4320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2222 SIMPSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABERDEEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98520-3514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-532-2222
Provider Business Practice Location Address Fax Number:
360-533-4320
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
W
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
360-532-2222

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  600404826 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X , with the licence number: 600404826 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 600404826 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 600404826 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9100009 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011669001 . This is a "GROUP HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 14596 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9016072 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9034190 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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