Provider Demographics
NPI:1942204706
Name:CONTINENTAL MEDICAL EQUIPMENT & SUPPLIES LLC
Entity Type:Organization
Organization Name:CONTINENTAL MEDICAL EQUIPMENT & SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINENYE
Authorized Official - Middle Name:KALU
Authorized Official - Last Name:MBA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:503-362-4600
Mailing Address - Street 1:3000 MARKET ST NE
Mailing Address - Street 2:STE 212
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1897
Mailing Address - Country:US
Mailing Address - Phone:503-362-4600
Mailing Address - Fax:503-362-4403
Practice Address - Street 1:3000 MARKET ST NE
Practice Address - Street 2:STE 212
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1897
Practice Address - Country:US
Practice Address - Phone:503-362-4600
Practice Address - Fax:503-362-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR125319-92332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06568Medicaid
LA1476820Medicaid
OR231980Medicaid
WA9054008Medicaid
OR231980Medicaid