MEDICARE: MULTICARE HEALTH SYSTEM

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	:	1801457056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTICARE HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	PO BOX 5299, MS: 737-3-PCON
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98415-0299
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 E 29TH AVE STE 100
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-4868
Country	:	US
Telephone Number	:	509-724-4320
Fax Number	:	509-232-0188

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT SPECIALIST
Name	:	CECILIA J CARTER
Credential	:
Telephone Number	:	253-459-8231

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	06/27/2019

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Directions to “MULTICARE HEALTH SYSTEM ” Practice Location

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