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Organization

STAT MEDICAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL ANTHONY CONFORTO (PRESIDENT/CEO)
(206) 621-1982
Entity
Organization

Contact information

Practice address
732 LEBO BLVD, BREMERTON, WA 98310-3325
(360) 792-2695
(360) 792-2697
Mailing address
21222 30TH DR SE, SUITE 210, BOTHELL, WA 98021-7069
(206) 621-1982
(425) 820-0831

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6012058040010007
WA
332BC3200X
Customized Equipment (DME)
6012058040010007
WA
332BN1400X
Nursing Facility Supplies (DME)
6012058040010007
WA
332BX2000X
Oxygen Equipment & Supplies (DME)
6012058040010007
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0066134
LABOR & INDUSTRIES
WA
05
9029265
WA
05
9038860
WA
05
9047085
WA
01
ST2365
REGENCE BLUE SHIELD
WA
Enumeration date
05/11/2006
Last updated
04/14/2009
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