AVAMERE MEDICAL SUPPLY LLC (NPI# 1104829258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104829258 |
| Entity Type | Organization |
| Organization Name | AVAMERE MEDICAL SUPPLY LLC |
| Other Organization Name | SIGNATURE MEDICAL SUPPLY |
| Practice Address |
25117 Sw Parkway Ave Ste F Wilsonville OR 97070-9697 |
| Practice Telephone | 5037832483 |
| Practice Fax Number | 5037832480 |
| Mailing Telephone | 5037832483 |
| Mailing Fax Number | 5037832480 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2010-01-21 |
| Authorized Official Name | MR. RICHARD A. DILLON (OWNER/COO) |
| Authorized Official Telephone | 9712242819 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9052515 | 05 | |
| AK | MS001OR | 05 | |
| OR | 230869 | 05 |
| Other Name | Type Code |
|---|---|
| Signature Medical Supply | Doing Business As Name - Organization |
| Street Address |
25117 SW PARKWAY AVE STE F |
| City | WILSONVILLE |
| State | OR |
| Zip Code | 97070-9697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184151805 | Jessica Beers | Speech-Language Pathologist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-05-11 |
| 1497280044 | Matthew Wayne | Physical Therapy Assistant | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070 | 2017-04-20 |
| 1336673029 | Mary Lawrence Williams | Physical Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-04-19 |
| 1447790191 | Rebecca Lauren Reinhardt | Occupational Therapist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-28 |
| 1821537911 | Catherine Bonde | Occupational Therapist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-22 |
| 1154860419 | Joy Hallett | Occupational Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-02-20 |
| 1205374931 | Lauryl James | Physical Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-02-01 |
| 1992243620 | Danielle Fernanda Jackovitz | Speech-Language Pathologist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-01 |
| 1124562822 | Andrea Earnest | Occupational Therapy Assistant | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2016-12-14 |
| 1730622507 | Kaileen Clift | Physical Therapy Assistant | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995896 | Rosalyn Sharon Mckinney | Technician | 7798 Sw Vlahos Dr, Wilsonville, OR 97070 | 2019-10-29 |
| 1275027393 | Oregon Regeneration Stem Cell Medical Center, LLC | Chiropractor | 29781 Sw Town Center Loop, Wilsonville, OR 97070 | 2018-06-21 |
| 1073050472 | Kirstin Marie Lauritzen | Chiropractor | 25589 Sw Canyon Creek Rd Ste 100, Wilsonville, OR 97070 | 2017-01-23 |
| 1932642220 | Nicole Galasso | Occupational Therapy Assistant | 25117 Sw Parkway Avenue Suite D, Wilsonville, OR 97070 | 2016-11-18 |
| 1508317512 | Justin Langlais | Naturopath | 25195 Sw Parkway Ave Ste 210, Wilsonville, OR 97070 | 2016-10-14 |
| 1518411149 | Stephanie Tran | Optometrist | 29250 Town Center Loop W, Wilsonville, OR 97070 | 2016-08-11 |
| 1346610607 | Rachel Ziegler | Occupational Therapy Assistant | 25117 Sw Parkway Ave Suite D, Willsonville, OR 97070 | 2015-09-30 |
| 1992184238 | Michelle Miranda | Counselor | 30150 Sw Parkway Ave Ste 300, Wilsonville, OR 97070 | 2015-05-19 |
| 1609275007 | Ryan Bridges | Dentist | 30040 Sw Boones Ferry Rd Ste 20, Wilsonville, OR 97070 | 2014-08-21 |
| 1649604018 | Jason Russell James | Physical Therapist | 29174 Sw Town Center Loop W # 202b, Wilsonville, OR 97070 | 2013-08-21 |
| Find all providers in zip 97070 | ||||
| Taxonomy Code | 332BN1400X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Nursing Facility Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891036554 | Fourth Dimension Corp | Durable Medical Equipment & Medical Supplies | 61148 Benham Rd, Bend, OR 97702-2652 | 2013-03-06 |
| 1164734539 | Sheer Medical LLC | Durable Medical Equipment & Medical Supplies | 903 Nw F St Ste C, Grants Pass, OR 97526-1838 | 2010-07-13 |
| 1477740827 | Olson Drug, Inc | Durable Medical Equipment & Medical Supplies | 16244 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2007-10-01 |
| 1801878293 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 3457 Ne Division St, Gresham, OR 97030-4602 | 2005-11-19 |
| 1073594867 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 970 W Juniper St, Hermiston, OR 97838-2197 | 2005-11-08 |
| 1811978216 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 1 Park Ave, Brookings, OR 97415-9145 | 2005-11-11 |
| City | WILSONVILLE |
| Zip Code | 97070 |
Please comment or provide details below to improve the information on AVAMERE MEDICAL SUPPLY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.