Provider Demographics
NPI:1235185711
Name:NORTHWEST DURABLE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:NORTHWEST DURABLE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FRANCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-581-1189
Mailing Address - Street 1:450 PINE ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-8316
Mailing Address - Country:US
Mailing Address - Phone:888-581-1189
Mailing Address - Fax:877-581-1190
Practice Address - Street 1:450 PINE ST NE
Practice Address - Street 2:SUITE 2
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-8316
Practice Address - Country:US
Practice Address - Phone:888-581-1189
Practice Address - Fax:877-581-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR005791Medicaid
5619220001Medicare NSC