Signature Medical Supply

LBN: Avamere Medical Supply Llc
Signature Medical Supply is an health care organization with primary practice located at 25117 Sw Parkway Ave Ste F, Wilsonville OR 97070-9697. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Suppliers / Nursing Facility Supplies is the primary health care specialty. Avamere Medical Supply Llc can be contacted via phone (503) 783-2483, or through Dillon, Richard A. via phone (971) 224-2819.

Contact Information

Primary practice address
25117 Sw Parkway Ave Ste F Wilsonville OR 97070-9697
Phone: (503) 783-2483
Fax: (503) 783-2480
Website:
Map and Directions
Authorized official contact:
Name: Dillon, Richard A.
Phone: (971) 224-2819

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Nursing Facility Supplies 332BN1400X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X

Profile Details

NPI number 1104829258
LBN Legal business name Avamere Medical Supply Llc
DBA Doing business as Signature Medical Supply
Authorized official Dillon, Richard A.
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2005
Last updated Jan 21st, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104829258 NPPES
Oregon MEDICAID 230869
Oregon MEDICAID 9052515
Oregon MEDICAID MS001OR

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