Healthcare Provider Details

I. General information

NPI: 1689312654
Provider Name (Legal Business Name): HOWARDS MEDICAL TRI CITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 STEVENS DR
RICHLAND WA
99352-3507
US

IV. Provider business mailing address

846 STEVENS DR
RICHLAND WA
99352-3507
US

V. Phone/Fax

Practice location:
  • Phone: 509-392-4422
  • Fax: 509-834-7414
Mailing address:
  • Phone: 509-392-4422
  • Fax: 509-834-7414

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ERIK DAVID MICKELSON
Title or Position: OWNER
Credential:
Phone: 509-941-5191