Active NPI
Patient Care Infusion LLC
Doing business as Arizona Home Care
- Home Infusion Therapy Pharmacy
- Tempe, AZ
National Provider Identifier
1295707933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Therapy Pharmacy
- License
- 2667
- Legal business name
- PATIENT CARE INFUSION LLC
- Doing business as
- Arizona Home Care
- Practice address
- 1626 S Edward Dr
Tempe, AZ 85281-6200 - Phone
- (602) 252-5000
- Fax
- (602) 323-5070
- NPI assigned
- Feb 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Allen Coston
- Title
- A R Manager
- Phone
- (602) 445-1745
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Y002667 | AZ | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 303 | AZ | |
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 303 | AZ | |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | C000303 | AZ | |
| Pharmacy | 333600000X | 2667 | AZ | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 2667 | AZ | Primary |
| Nuclear Pharmacy | 3336N0007X | 7572 | AZ |
Addresses
Primary practice location
1626 S Edward Dr
Tempe, AZ 85281-6200
Mailing address
1626 S Edward Dr
Tempe, AZ 85281-6200
Phone (602) 252-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31251201 | Medicaid | AZ | |
| 100500730 | Medicaid | NV |
Other names 1
- Arizona Home Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930027692 | AZ | DME Supplier - Pharmacy | 5193845543 |
1 other NPI on this enrollment Practice locations: Tempe, AZ |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Arizona Home Care
- Durable Medical Equipment & Medical Supplies
- Tempe, AZ
- NPI 1669692331
O20100930027692
National Provider Directory
National Provider Directory- Tax ID family
- Patient Care Infusion LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1334880000000",
"number": "1295707933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 S EDWARD DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852816200",
"telephone_number": "602-252-5000",
"fax_number": "602-323-5070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1626 S EDWARD DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852816200",
"telephone_number": "602-252-5000",
"fax_number": "602-323-5070"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PATIENT CARE INFUSION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-06",
"last_updated": "2012-04-20",
"status": "A",
"authorized_official_last_name": "COSTON",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "ALLEN",
"authorized_official_title_or_position": "A R MANAGER",
"authorized_official_telephone_number": "602-445-1745",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "AZ",
"license": "Y002667",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "AZ",
"license": "303",
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "AZ",
"license": "303",
"primary": false
},
{
"code": "332BX2000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
"state": "AZ",
"license": "C000303",
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "AZ",
"license": "2667",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "AZ",
"license": "2667",
"primary": true
},
{
"code": "3336N0007X",
"taxonomy_group": "",
"desc": "Pharmacy, Nuclear Pharmacy",
"state": "AZ",
"license": "7572",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31251201",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100500730",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Arizona Home Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.