Healthcare Provider Details

I. General information

NPI: 1518041334
Provider Name (Legal Business Name): TIMS HOME MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 DORA AVE W
BREMERTON WA
98312-3657
US

IV. Provider business mailing address

PO BOX 3256
BREMERTON WA
98310-0441
US

V. Phone/Fax

Practice location:
  • Phone: 360-782-1922
  • Fax: 360-782-2255
Mailing address:
  • Phone: 360-782-1922
  • Fax: 360-782-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number602185162
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY JOHN NESHEM
Title or Position: PRESIDENT
Credential:
Phone: 360-782-1922