Provider Demographics
NPI:1740592138
Name:PACIFIC BIOMEDICAL INC
Entity Type:Organization
Organization Name:PACIFIC BIOMEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-264-3242
Mailing Address - Street 1:705 E GRANADA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2193
Mailing Address - Country:US
Mailing Address - Phone:480-264-3242
Mailing Address - Fax:480-718-8900
Practice Address - Street 1:705 E GRANADA RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2193
Practice Address - Country:US
Practice Address - Phone:480-264-3242
Practice Address - Fax:480-718-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZW001695332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment