Provider Demographics
NPI:1922248749
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:800-445-9622
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:800-445-9622
Mailing Address - Fax:615-771-8849
Practice Address - Street 1:3601 SE COLUMBIA WAY
Practice Address - Street 2:SUITE 190
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-8056
Practice Address - Country:US
Practice Address - Phone:360-695-6461
Practice Address - Fax:360-695-3064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE MEDICAL SUPPLY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-06
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR228870Medicaid