Healthcare Provider Details

I. General information

NPI: 1750609202
Provider Name (Legal Business Name): CASCADE MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 GLOBE CENTER DR SUITE 110
MORRISVILLE NC
27560-6203
US

IV. Provider business mailing address

PO BOX 681646
FRANKLIN TN
37068-1646
US

V. Phone/Fax

Practice location:
  • Phone: 919-484-8852
  • Fax: 919-544-9703
Mailing address:
  • Phone: 615-771-8839
  • Fax: 615-771-8849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: THEODORE M HIRSCH
Title or Position: VP OPERATIONS
Credential:
Phone: 615-771-8839