Provider Demographics
NPI:1760243398
Name:KEYBRIDGE HEALTH SUPPLIES PLLC
Entity Type:Organization
Organization Name:KEYBRIDGE HEALTH SUPPLIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:360-334-3216
Mailing Address - Street 1:3516 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5011
Mailing Address - Country:US
Mailing Address - Phone:360-334-3216
Mailing Address - Fax:
Practice Address - Street 1:3516 7TH AVE SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5011
Practice Address - Country:US
Practice Address - Phone:360-334-3216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies