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NPI Code Detail

MEDICARE: MARY BRIDGE CHILDREN'S HOSPITAL

MEDICARE: MARY BRIDGE CHILDREN'S HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NC2000XChildren's Hospital
2283XC2000XChildren's Rehabilitation Hospital
3332BC3200XCustomized Equipment (DME)
4332BD1200XDialysis Equipment & Supplies (DME)
5332BP3500XParenteral & Enteral Nutrition Supplies (DME)
6332BX2000XOxygen Equipment & Supplies (DME)
7333600000XPharmacy
8335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
9332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1063739936
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY BRIDGE CHILDREN'S HOSPITAL
Provider Business Mailing Address
First Line : 317 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-403-1420
Fax Number :
Provider Business Practice Location Address
First Line : 317 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-403-1420
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : VINCET H SCHMITZ
Credential : CFO
Telephone Number : 253-459-8000
Provider Enumeration Date : 04/30/2010
Last Update Date : 04/30/2010

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Directions to “MARY BRIDGE CHILDREN'S HOSPITAL ” Practice Location

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