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General NPI Number Information
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NPI Number | 1023893658
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Entity Type | Organization
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Legal Business Name | KEYBRIDGE HEALTH SUPPLIES LLC
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 3516 7TH AVE SW
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City | OLYMPIA
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State | WA
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Zip | 98502-5011
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Country | US
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Telephone | 646-671-9790
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Fax | 253-444-0533
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Provider Business Mailing Address
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Address Line | 3516 7TH AVE SW
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City | OLYMPIA
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State | WA
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Zip | 98502-5011
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Country | US
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Telephone | 646-671-9790
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Fax | 253-444-0533
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Authorized Official
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Title or Position | OWNER
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Name | MR. KERBIE SALVADOR A BARRANTES
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Credential |
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Telephone | 646-671-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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