Provider Demographics
NPI:1598908360
Name:MEDIUS MEDICAL CONCEPTS, INC.
Entity Type:Organization
Organization Name:MEDIUS MEDICAL CONCEPTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-459-5500
Mailing Address - Street 1:111 SW 5TH AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3604
Mailing Address - Country:US
Mailing Address - Phone:503-459-5500
Mailing Address - Fax:503-459-5515
Practice Address - Street 1:111 SW 5TH AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3604
Practice Address - Country:US
Practice Address - Phone:503-459-5500
Practice Address - Fax:503-459-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment