Healthcare Provider Details

I. General information

NPI: 1033149000
Provider Name (Legal Business Name): NORTHWEST MEDICAL, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5633 B ST
ANCHORAGE AK
99518-1642
US

IV. Provider business mailing address

2330 W BROADWAY RD STE 107
MESA AZ
85202-1886
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-0073
  • Fax: 907-561-0576
Mailing address:
  • Phone: 480-830-7700
  • Fax: 480-750-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GREGORY J CRAWFORD
Title or Position: PRESIDENT
Credential:
Phone: 859-441-8876