Organization
DEACON'S MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER DEACON (OWNER)
(509) 397-3345
Entity
Organization
Contact information
Practice address
118 N. MAIN ST., COLFAX, WA 99111
(509) 397-3345
(509) 397-2966
Mailing address
118 N. MAIN ST., COLFAX, WA 99111
(509) 397-3345
(509) 397-2966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
601678679
WA
332BD1200X
Dialysis Equipment & Supplies (DME)
601678679
WA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
601678679
WA
332BX2000X
Oxygen Equipment & Supplies (DME)
601678679
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805724000
—
ID
05
—
9009283
—
WA
05
—
9041856
—
WA
05
—
9041864
—
WA
Enumeration date
08/14/2006
Last updated
07/29/2008
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