Provider Demographics
NPI:1154511137
Name:SSF BARGAIN WAREHOUSE LLC
Entity Type:Organization
Organization Name:SSF BARGAIN WAREHOUSE LLC
Other - Org Name:BARGAIN WAREHOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STURGIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-452-3936
Mailing Address - Street 1:181 KEMP ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-8991
Mailing Address - Country:US
Mailing Address - Phone:360-452-3936
Mailing Address - Fax:360-452-5045
Practice Address - Street 1:181 KEMP ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-8991
Practice Address - Country:US
Practice Address - Phone:360-452-3936
Practice Address - Fax:360-452-5045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5682610001Medicare NSC