Eagle Cap Coffee LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EAGLE CAP COFFEE LLC

Practice address

30 S Louisiana St Ste 211
Kennewick, WA 99336-9003

Phone

(509) 572-3972

Fax

(509) 572-3968

NPI assigned

Feb 15, 2024

Organization subpart

No

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

Authorized official

Name

Marie Johansing

Title

Co-Owner

Phone

(509) 539-9536

Specialties & licenses 1

Addresses

Other names 1

• SYNERGY HomeCare of Tri-Cities Doing business as

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1578328811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S LOUISIANA ST STE 211",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993369003",
            "telephone_number": "509-572-3972",
            "fax_number": "509-572-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S LOUISIANA ST STE 211",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993369003",
            "telephone_number": "509-572-3972",
            "fax_number": "509-572-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE CAP COFFEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "JOHANSING",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "509-539-9536"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SYNERGY HomeCare of Tri-Cities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Ruth Dunn, RPH
• Aylin G Duran Torralba, SUDPT
• Kassidy Durbin
• Lindsay Paige Dye, M.A.
• Stephanie A Dynarski
• Arielle Eaton
• Jose L Echeverria Jr.
• Vicky K Ecker, LMP
• Sharon Edgar, RN
• Brittany Edgmand

• In Home Supportive Care Agency in Kennewick, WA
• Providers in Kennewick, WA by specialty
• In Home Supportive Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.