Provider Demographics
NPI:1275703084
Name:SOUND HEALTH MEDICAL SUPPLY
Entity Type:Organization
Organization Name:SOUND HEALTH MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:TEBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-225-6770
Mailing Address - Street 1:2811 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2746
Mailing Address - Country:US
Mailing Address - Phone:253-274-5000
Mailing Address - Fax:253-572-3111
Practice Address - Street 1:2811 S 12TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2746
Practice Address - Country:US
Practice Address - Phone:253-274-5000
Practice Address - Fax:253-572-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9062738Medicaid
WA6316310001Medicare NSC