Active NPI
Preferred Homecare Infusion LLC
- Home Infusion Agency
- Spokane Valley, WA
National Provider Identifier
1629089362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Agency
- License
- 60202268
- 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, 2018
- 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
- William Keys
- Title
- Ceo
- Phone
- (480) 446-9010
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2086032 | Medicaid | WA |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
- Sleep Disorder Diagnostic Clinic/Center
- Avondale, AZ
- NPI 1124185350
Member Of
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.