Sutter Visiting Nurse Association and Hospice
Organization Active NPI Home Infusion Therapy Pharmacy · Alameda, CA
NPI 1255401477 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1255401477
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Infusion Therapy Pharmacy 3336H0001X
- License
- PHY 47212 (CA)
- Legal business name
- SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
- Practice address
- 1105 Atlantic Ave
Ste 102
Alameda, CA 94501-1184 - Phone
- (510) 450-8900
- Fax
- (510) 652-8278
- NPI assigned
- Nov 8, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SUTTER VISITING NURSE ASSOICATION AND HOSPICE
Authorized official
- Name
- Mr. Mark K McPherson
- Title
- Ceo
- Phone
- (707) 864-4660
Corporate family (same tax ID) 38
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Sutter Infusion & Pharmacy Services |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930081450 | CA | DME Supplier - Pharmacy | 1052228673 | Practice locations: Alameda, CA |
National Provider Directory
- Tax ID family
- Sutter Visiting Nurse
- Part of
- Sutter Visiting Nurse
Locations
4830 Business Center Dr
Ste 140
Fairfield, CA 94534
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Compounding Pharmacy | 3336C0004X | LSC 99512 | CA | |
| Home Infusion Therapy Pharmacy | 3336H0001X | PHY 47212 | CA | Yes |
Addresses
Primary practice location
1105 Atlantic Ave
Ste 102
Alameda, CA 94501-1184
Mailing address
4830 Business Center Dr
Ste 140
Fairfield, CA 94534-1797
Phone (855) 771-0328
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ 098992 | Other | CA | SUTTER INFUSION PHARMACY |
| ZZZ02700Z | Other | CA | SUTTER INFUSION PHARMACY |
| 1071252 | Other | CA | SUTTER INFUSION PHARMACY |
| PHA472120 | Medicaid | CA |
Other names
- Sutter Infusion & Pharmacy Services
Other providers in Alameda, CA
- Russell William Sunderland Jr.
- Preeti Gill Suppal
- Kaylee Stevie Surrell II
- Sutter Gould Medical Foundation
- Sutter Visiting Nurse Association and Hospice
- Kiara Swanier
- Evan Alexander Swarth
- Melanie Ann Sweeney Griffith I
- Neil Jason Sweet
- Jonah Bryant Swensen
All providers in Alameda, CA · Home Infusion Therapy Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.