Provider Demographics
NPI:1962454009
Name:BUNCE RENTAL, INC
Entity type:Organization
Organization Name:BUNCE RENTAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAISDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-848-1254
Mailing Address - Street 1:1812 E MAIN
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3146
Mailing Address - Country:US
Mailing Address - Phone:253-848-1254
Mailing Address - Fax:253-845-3402
Practice Address - Street 1:1812 E MAIN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3146
Practice Address - Country:US
Practice Address - Phone:253-848-1254
Practice Address - Fax:253-845-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9245804Medicaid
WA9245804Medicaid