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General NPI Number Information
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NPI Number | 1568412435
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Entity Type | Organization
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Legal Business Name | STAT MEDICAL INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 732 LEBO BLVD
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City | BREMERTON
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State | WA
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Zip | 98310-3325
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Country | US
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Telephone | 360-792-2695
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Fax | 360-792-2697
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Provider Business Mailing Address
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Address Line | 21222 30TH DR SE SUITE 210
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City | BOTHELL
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State | WA
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Zip | 98021-7069
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Country | US
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Telephone | 206-621-1982
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Fax | 425-820-0831
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MICHAEL ANTHONY CONFORTO
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Credential |
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Telephone | 206-621-1982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 6012058040010007
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 6012058040010007
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 6012058040010007
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 6012058040010007
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License Number State | WA
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