MEDICARE: PACIFIC MEDICAL SUPPLIES, 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	:	1700058443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	3221 NOLENSVILLE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-2968
Country	:	US
Telephone Number	:	615-479-4808
Fax Number	:	675-834-3335

Provider Business Practice Location Address
First Line	:	3221 NOLENSVILLE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-2968
Country	:	US
Telephone Number	:	615-479-4808
Fax Number	:	675-834-3335

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOSHUA GBASIN
Credential	:
Telephone Number	:	615-479-4808

Provider Enumeration Date	:	04/01/2008
Last Update Date	:	04/01/2008

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