Organization
GENEVA WOODS HEALTH SUPPLIES PNW, LLC
Active
Other names
MyMedSupplies
Organization subpart
No
Provider details
NPI number
Authorized official
DAN AFRASIABI (PRESIDENT/AUTHORIZED OFFICIAL)
(888) 441-1312
Entity
Organization
Contact information
Practice address
6149 MARTIN WAY E, LACEY, WA 98516-5547
(360) 456-5475
(360) 456-5182
Mailing address
PO BOX 94347, SEATTLE, WA 98124-6647
(509) 588-7241
(866) 583-9296
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
604-124-465
WA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
604-124-465
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942339015
—
ID
05
—
2092007
—
WA
05
—
500736762
—
OR
Enumeration date
03/05/2007
Last updated
09/09/2021
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