Provider Demographics
NPI:1962687970
Name:PACIFIC BIOMEDICAL DME LLC
Entity Type:Organization
Organization Name:PACIFIC BIOMEDICAL DME LLC
Other - Org Name:PACIFIC BIOMEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:760-561-9648
Mailing Address - Street 1:3790 VIA DE LA VALLE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-4247
Mailing Address - Country:US
Mailing Address - Phone:760-402-5807
Mailing Address - Fax:
Practice Address - Street 1:3790 VIA DE LA VALLE
Practice Address - Street 2:SUITE 108
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4247
Practice Address - Country:US
Practice Address - Phone:760-402-5807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies