Provider Demographics
NPI: | 1346907714 |
---|---|
Name: | PERFORMANCE MODALITIES INC |
Entity Type: | Organization |
Organization Name: | PERFORMANCE MODALITIES INC |
Other - Org Name: | PERFORMANCE HOME MEDICAL |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | MANAGER OF COMPLIANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LUANA |
Authorized Official - Middle Name: | MICHELE |
Authorized Official - Last Name: | HALL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-569-4601 |
Mailing Address - Street 1: | PO BOX 94307 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98124-6607 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 866-687-4463 |
Mailing Address - Fax: | 877-414-2727 |
Practice Address - Street 1: | 3800 BYRON AVE STE 136 |
Practice Address - Street 2: | |
Practice Address - City: | BELLINGHAM |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98229-2877 |
Practice Address - Country: | US |
Practice Address - Phone: | 866-687-4463 |
Practice Address - Fax: | 877-414-2727 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-11-20 |
Last Update Date: | 2023-03-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |