Provider Demographics
NPI:1245504281
Name:MABUHAY MEDICAL SUPPLY AND EQUIPMENT
Entity type:Organization
Organization Name:MABUHAY MEDICAL SUPPLY AND EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:DAYA
Authorized Official - Last Name:JAMERO
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:206-992-8790
Mailing Address - Street 1:PO BOX 2328
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-2328
Mailing Address - Country:US
Mailing Address - Phone:206-992-8790
Mailing Address - Fax:
Practice Address - Street 1:3333 164TH ST SW
Practice Address - Street 2:UNIT 1038
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-3150
Practice Address - Country:US
Practice Address - Phone:206-992-8790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603170278332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies