Provider Demographics
NPI:1023893658
Name:KEYBRIDGE HEALTH SUPPLIES LLC
Entity type:Organization
Organization Name:KEYBRIDGE HEALTH SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KERBIE SALVADOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-671-9790
Mailing Address - Street 1:3516 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5011
Mailing Address - Country:US
Mailing Address - Phone:646-671-9790
Mailing Address - Fax:253-444-0533
Practice Address - Street 1:3516 7TH AVE SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5011
Practice Address - Country:US
Practice Address - Phone:646-671-9790
Practice Address - Fax:253-444-0533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service