Organization
AVAMERE MEDICAL SUPPLY LLC
Active
Other names
Signature Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A. DILLON (OWNER/COO)
(971) 224-2819
Entity
Organization
Contact information
Practice address
25117 SW PARKWAY AVE, STE F, WILSONVILLE, OR 97070-9697
(503) 783-2483
(503) 783-2480
Mailing address
25117 SW PARKWAY AVE, STE F, WILSONVILLE, OR 97070-9697
(503) 783-2483
(503) 783-2480
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230869
—
OR
05
—
9052515
—
WA
05
—
MS001OR
—
AK
Enumeration date
05/23/2005
Last updated
01/21/2010
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