MEDICARE: PACIFIC MEDICAL, INC.

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	:	1598561938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC MEDICAL, INC.

Provider Business Mailing Address
First Line	:	1700 N CHRISMAN RD
Second Line	:
City	:	TRACY
State	:	CA
Zip	:	95304-9314
Country	:	US
Telephone Number	:	800-726-9180
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 EDELWEISS DR
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-3933
Country	:	US
Telephone Number	:	406-698-2296
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL/CLO
Name	:	MARK WEAVER
Credential	:	ESQ.
Telephone Number	:	800-723-9180

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/24/2025

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