Provider Demographics
NPI:1487715702
Name:COMMED, INC.
Entity type:Organization
Organization Name:COMMED, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:360-546-3839
Mailing Address - Street 1:PO BOX 65174
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-0006
Mailing Address - Country:US
Mailing Address - Phone:360-546-3839
Mailing Address - Fax:360-546-3841
Practice Address - Street 1:10215 NE 41ST AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-5812
Practice Address - Country:US
Practice Address - Phone:360-546-3839
Practice Address - Fax:360-546-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5228370001OtherMEDICARE LEGACY IDENTIFIERS