Provider Demographics
NPI:1982786679
Name:REM MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:REM MEDICAL EQUIPMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-491-1065
Mailing Address - Street 1:190 QUEEN ANNE AVE N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4968
Mailing Address - Country:US
Mailing Address - Phone:206-285-5100
Mailing Address - Fax:206-285-5110
Practice Address - Street 1:215 S POWER RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5235
Practice Address - Country:US
Practice Address - Phone:480-641-0442
Practice Address - Fax:480-393-7061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20063329-R332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5795190002Medicare NSC
AZ103987Medicare UPIN