Provider Demographics
NPI:1528252376
Name:KALAM MEDICAL SUPPLIES
Entity type:Organization
Organization Name:KALAM MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAMKERYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-234-7949
Mailing Address - Street 1:1233 SE POWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2437
Mailing Address - Country:US
Mailing Address - Phone:503-234-7949
Mailing Address - Fax:503-234-7950
Practice Address - Street 1:1233 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2437
Practice Address - Country:US
Practice Address - Phone:503-234-7949
Practice Address - Fax:503-234-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6033590001Medicare NSC