Provider Demographics
NPI:1891035465
Name:PACIFIC ENTERPRISES, INC.
Entity Type:Organization
Organization Name:PACIFIC ENTERPRISES, INC.
Other - Org Name:ALLCARE, LEGSMART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-323-9917
Mailing Address - Street 1:PO BOX 53122
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-3122
Mailing Address - Country:US
Mailing Address - Phone:425-455-8330
Mailing Address - Fax:425-453-7294
Practice Address - Street 1:1048 116TH AVE NE
Practice Address - Street 2:SUITE 130
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4640
Practice Address - Country:US
Practice Address - Phone:425-455-8330
Practice Address - Fax:425-453-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment