Provider Demographics
NPI:1245378405
Name:TERRY L RIVETT
Entity Type:Organization
Organization Name:TERRY L RIVETT
Other - Org Name:MEDICAL SUPPLY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RIVETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-427-6200
Mailing Address - Street 1:535 ELLINOR AVE
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-3210
Mailing Address - Country:US
Mailing Address - Phone:360-427-6200
Mailing Address - Fax:360-427-6300
Practice Address - Street 1:535 ELLINOR AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3210
Practice Address - Country:US
Practice Address - Phone:360-427-6200
Practice Address - Fax:360-427-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602683771332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies