Provider Demographics
NPI:1336389188
Name:GARTH PFEIFER
Entity Type:Organization
Organization Name:GARTH PFEIFER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PORPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PFEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-547-8529
Mailing Address - Street 1:620 SE OAK ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4160
Mailing Address - Country:US
Mailing Address - Phone:503-547-8529
Mailing Address - Fax:503-547-8529
Practice Address - Street 1:620 SE OAK ST
Practice Address - Street 2:SUITE F
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4160
Practice Address - Country:US
Practice Address - Phone:503-547-8529
Practice Address - Fax:503-547-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1309660001Medicare NSC