Organization
PACIFIC, INC.
Active
Other names
Pacific Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FATEMEH PANAHI RN BSN (PRESIDENT)
(303) 377-8833
Entity
Organization
Contact information
Practice address
1595 HARLAN ST, LAKEWOOD, CO 80214-1535
(303) 237-0941
(303) 237-0942
Mailing address
1595 HARLAN ST, LAKEWOOD, CO 80214-1535
(303) 237-0941
(303) 237-0942
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
42-39832-0000
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77601319
—
CO
Enumeration date
02/21/2007
Last updated
08/22/2020
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