MEDICARE: PACIFIC PHYSICIAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1104019983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC PHYSICIAN SERVICES

Provider Business Mailing Address
First Line	:	4000 MERIDIAN BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-6325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 PORTAGE LAKES DR
Second Line	:	STE. B
City	:	AKRON
State	:	OH
Zip	:	44319-2299
Country	:	US
Telephone Number	:	330-645-6934
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROVIDER ENROLLMENT
Name	:	DEBBIE BREWER
Credential	:
Telephone Number	:	615-465-7000

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

Similar Medicare Providers

1861454449 — PACIFIC PHYSICIAN SERVICES, LLC
Practice Location Address:

500 PORTAGE LAKES DR , STE. B
AKRON, OH
44319-2299

Practice Phone: 330-645-6934
Practice Fax:

1558465013 — VALERIE A JOHNSON M.D.
Practice Location Address:

500 PORTAGE LAKES DR , STE. B
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1275718850 — SUMMA PHYSICIANS LLC
Practice Location Address:

500 PORTAGE LAKES DR , SUITE B
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Practice Phone: 330-375-7055
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1891734166 — SUMMA PHYSICIANS LLC
Practice Location Address:

500 PORTAGE LAKES DR STE A
COVENTRY TOWNSHIP, OH
44319-2299

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Practice Fax:

1437494176 — SUMMA PHYSICIANS LLC
Practice Location Address:

500 PORTAGE LAKES DR STE A
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1801399415 — JESSICA RAE BUSSEY
Practice Location Address:

500 PORTAGE LAKES DR
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Practice Phone: 234-867-6626
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Directions to “PACIFIC PHYSICIAN SERVICES ” Practice Location

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