Organization Active NPI

Helios Healthcare, LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Fremont, CA
National Provider Identifier
1124047386
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
License
4935510007 Issued in CA
Legal business name
HELIOS HEALTHCARE, LLC
Practice address
2500 Country Dr
Fremont, CA 94536-5356
Phone
(510) 792-4242
Fax
(510) 792-4646
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Michelle Smith
Title
Executive Director Reimbursement
Phone
(209) 955-2364

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 4935510007 CA Primary

Addresses

Primary practice location

2500 Country Dr
Fremont, CA 94536-5356

Mailing address

7590 Shoreline Dr
Stockton, CA 95219-5455
Phone (209) 955-2328

Other identifiers 2

IdentifierTypeStateIssuer
4935510007OtherCAPART B SUPPLIER
ZZR05885IMedicaidCA

Other names 1

  • COUNTRY DRIVE CARE CENTER Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1124047386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 SHORELINE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195455",
            "telephone_number": "209-955-2328",
            "fax_number": "209-478-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365356",
            "telephone_number": "510-792-4242",
            "fax_number": "510-792-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELIOS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "209-955-2364"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": "4935510007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B SUPPLIER",
            "identifier": "4935510007",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05885I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTRY DRIVE CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.