Provider Demographics
NPI:1649571522
Name:CASCADE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:CASCADE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-771-8839
Mailing Address - Street 1:PO BOX 681646
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1646
Mailing Address - Country:US
Mailing Address - Phone:615-771-8839
Mailing Address - Fax:615-550-7400
Practice Address - Street 1:4 THATCHER LN
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-1070
Practice Address - Country:US
Practice Address - Phone:800-526-6607
Practice Address - Fax:508-291-2392
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE MEDICAL SUPPLY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-09
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602158743332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5072650001Medicare NSC