Provider Demographics
NPI:1215262738
Name:SOUND HEALTH MEDICAL SUPPLY
Entity type:Organization
Organization Name:SOUND HEALTH MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TEBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-225-6770
Mailing Address - Street 1:2811 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2746
Mailing Address - Country:US
Mailing Address - Phone:253-274-5000
Mailing Address - Fax:253-572-3111
Practice Address - Street 1:10130 SW NIMBUS AVE
Practice Address - Street 2:STE D9
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-639-9501
Practice Address - Fax:503-639-9634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6316310002Medicare NSC