Petersons Home Care Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PETERSONS HOME CARE INC

Doing business as

ROTECH

Practice address

1991 Industrial Blvd Ste 101
Lake Havasu City, AZ 86403-3615

Phone

(928) 669-8285

Fax

(928) 669-5330

NPI assigned

Jan 18, 2006

Organization subpart

Yes

Parent organization

ROTECH HEALTHCARE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Robin L Menchen

Title

Chief Executive Officer

Phone

(407) 822-4600

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• ROTECH Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Part of

Rotech Healthcare Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1043290885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27968",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270968",
            "telephone_number": "570-966-8030",
            "fax_number": "570-966-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 INDUSTRIAL BLVD STE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864033615",
            "telephone_number": "928-669-8285",
            "fax_number": "928-669-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSONS HOME CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROTECH HEALTHCARE INC",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "MENCHEN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-822-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444753",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROTECH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROTECH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Jean Perry, MD
• Melissa Peru
• Kishore Perumandla
• Brian Peters, MD
• Robert D Peterson, MD
• PHC-Lake Havasu Inc
• Douglas George Pheling, MA
• Philip a St Raymond MD PLLC
• Cassidy Phoenix
• Physicians Integrated Health Group LLC

• Durable Medical Equipment & Medical Supplies in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.