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Organization

HEALTH CARE SUPPLY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN PECK (OWNER)
(360) 676-8707
Entity
Organization

Contact information

Practice address
1701 N STATE ST, BELLINGHAM, WA 98225-4604
(360) 676-8707
(360) 676-8707
Mailing address
1701 N STATE ST, BELLINGHAM, WA 98225-4604
(360) 676-8707
(360) 676-8707

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
600050758
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0013349
WA STATE L&I PIN
WA
01
103961001
GROUP HEALTH PIN
WA
05
9008632
WA
05
9142308
WA
01
HE1469
REGENCE BLUE SHIELD PIN
WA
Enumeration date
04/23/2007
Last updated
10/23/2008
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