Provider Demographics
NPI:1518041334
Name:TIMS HOME MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:TIMS HOME MEDICAL SUPPLIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:NESHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-782-1922
Mailing Address - Street 1:PO BOX 3256
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-0441
Mailing Address - Country:US
Mailing Address - Phone:360-782-1922
Mailing Address - Fax:360-782-2255
Practice Address - Street 1:199 DORA AVE W
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-3657
Practice Address - Country:US
Practice Address - Phone:360-782-1922
Practice Address - Fax:360-782-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
WA602185162332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9048836Medicaid
WA4454560001Medicare NSC