Provider Demographics
NPI:1104348887
Name:CARENET MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:CARENET MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAUDENMIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-974-0347
Mailing Address - Street 1:12425 SE RIVER RD APT 18
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-8074
Mailing Address - Country:US
Mailing Address - Phone:503-974-0347
Mailing Address - Fax:503-974-2212
Practice Address - Street 1:4020 SE INTERNATIONAL WAY STE C106
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6068
Practice Address - Country:US
Practice Address - Phone:503-974-0348
Practice Address - Fax:503-974-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment