Organization
EMMANUEL MEDICAL SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAESUNG PARK (OWNER)
(253) 529-2364
Entity
Organization
Contact information
Practice address
31260 PACIFIC HWY S, STE 8, FEDERAL WAY, WA 98003-5448
(253) 529-2364
(253) 529-2364
Mailing address
31260 PACIFIC HWY S, STE 8, FEDERAL WAY, WA 98003-5448
(253) 529-2364
(253) 529-2364
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6009914
—
WA
Enumeration date
11/17/2006
Last updated
05/01/2008
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