Healthcare Provider Details

I. General information

NPI: 1679681787
Provider Name (Legal Business Name): NORTHERN MEDICAL SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332902 HIGHWAY 2
NEWPORT WA
99156-5165
US

IV. Provider business mailing address

PO BOX 810
CHEWELAH WA
99109-0810
US

V. Phone/Fax

Practice location:
  • Phone: 509-447-5332
  • Fax: 509-447-2814
Mailing address:
  • Phone: 509-935-4020
  • Fax: 509-935-4975

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY HOLMES
Title or Position: OWNER
Credential:
Phone: 509-935-4020