Organization Active NPI

Preferred Homecare Infusion LLC

  • Home Infusion Agency
  • Spokane Valley, WA
National Provider Identifier
1629089362
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
60202268 Issued in WA
Legal business name
PREFERRED HOMECARE INFUSION LLC
Practice address
11703 E Sprague Ave Ste C3
Spokane Valley, WA 99206
Phone
(509) 921-6560
Fax
(509) 921-6551
NPI assigned
Aug 10, 2006
Last updated
Aug 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Authorized official

Name
William Keys
Title
Ceo
Phone
(480) 446-9010

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X 60202268 WA Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 60202268 WA
Oxygen Equipment & Supplies (DME) 332BX2000X 60202268 WA
Home Infusion Therapy Pharmacy 3336H0001X 60202268 WA
Mail Order Pharmacy 3336M0002X 1820MS ID
Mail Order Pharmacy 3336M0002X RP 001683 CS OR

Addresses

Primary practice location

11703 E Sprague Ave Ste C3
Spokane Valley, WA 99206

Mailing address

PO Box 40700
Mesa, AZ 85274-0700
Phone (480) 446-9010

Other identifiers 1

IdentifierTypeStateIssuer
2086032MedicaidWA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

11703 E Sprague Ave
Ste C3
Spokane Valley, WA 99206
Phone (509) 533-9003

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533513600000",
    "number": "1629089362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40700",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852740700",
            "telephone_number": "480-446-9010",
            "fax_number": "480-993-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 E SPRAGUE AVE STE C3",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-921-6560",
            "fax_number": "509-921-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED HOMECARE INFUSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-08-06",
        "status": "A",
        "authorized_official_last_name": "KEYS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-446-9010"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "WA",
            "license": "60202268",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WA",
            "license": "60202268",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WA",
            "license": "60202268",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WA",
            "license": "60202268",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "ID",
            "license": "1820MS",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "OR",
            "license": "RP 001683 CS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086032",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.