OPTION 1 NORTHWEST ENTERAL LLC (NPI# 1043398407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043398407 |
| Entity Type | Organization |
| Organization Name | OPTION 1 NORTHWEST ENTERAL LLC |
| Other Organization Name | AVEANNA HEALTHCARE MEDICAL SOLUTIONS |
| Practice Address |
8633 South 212th Street Kent WA 98031 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 8888852386 |
| Practice Fax Number | 8885993448 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7702488192 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | VICKI WHITESIDE (DIRECTOR REGULATORY LICENSING) |
| Authorized Official Telephone | 7702488740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9058462 | 05 | |
| WA | 9058470-02 | 05 |
| Other Name | Type Code |
|---|---|
| Aveanna Healthcare Medical Solutions | Doing Business As Name - Organization |
| Epic Medical Solutions | Doing Business As Name - Organization |
| Street Address |
8633 SOUTH 212TH STREET |
| City | KENT |
| State | WA |
| Zip Code | 98031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043325 | Deanna Lila Fuller | Technician | 21417 122nd Place Se, Kent, WA 98031 | 2019-09-26 |
| 1386092054 | Amninder Ripsy Nagra-kaur | Licensed Practical Nurse | 10016 Se 218th Pl, Kent, WA 98031 | 2016-06-02 |
| 1033575113 | Amanda Jane Holen | Nurse Practitioner | 202 State Avenue North, Kent, WA 98031 | 2016-01-05 |
| 1578951281 | Katherine Mitchell | Counselor | 12400 Se 233rd St, Kent, WA 98031 | 2015-01-03 |
| 1376804997 | San Lwai | Internal Medicine | 20040 - 120th Ave S.e., Kent, WA 98031 | 2012-05-30 |
| 1013106822 | Fiorella Andrea Diaz | Interpreter | 20029 104th Place Se, Kent, WA 98031 | 2007-10-17 |
| 1750599361 | Northwest Transport | Non-emergency Medical Transport (VAN) | 22627 85th Pl S, Kent, WA 98031 | 2007-05-18 |
| 1750596953 | Rhonda H. James | Licensed Practical Nurse | 21252 94th Pl. S, Kent, WA 98031 | 2007-05-11 |
| 1124172846 | Jeffrey W Baxter | Counselor | 10024 Se 240th, Suite 116 James Street Building, Kent, WA 98031 | 2007-01-22 |
| 1285610808 | Amber Elise Bryan | Pharmacy Technician | 230240 88th Ave S Apt Ww-202, Kent, WA 98031 | 2005-12-15 |
| Find all providers in zip 98031 | ||||
| Taxonomy Code | 332BP3500X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Parenteral & Enteral Nutrition |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841832466 | Optum Infusion Services 501 Inc | Durable Medical Equipment & Medical Supplies | 8131 West Bostian Road, Suite A345, Woodinville, WA 98072 | 2019-10-15 |
| 1598207482 | Hygeia II Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 4205 E Blaine St, Seattle, WA 98112-3229 | 2016-11-09 |
| 1174917579 | Geneva Woods Health Supplies Pnw, LLC | Durable Medical Equipment & Medical Supplies | 6326 E Trent Ave Ste A, Spokane Valley, WA 99212-1220 | 2015-03-24 |
| 1043604655 | Geneva Woods Health Supplies Pnw, LLC | Durable Medical Equipment & Medical Supplies | 6600 Ne 112th Ct Ste 101, Vancouver, WA 98662-5496 | 2015-03-20 |
| 1871889212 | Option Care Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 3310 N Pines Rd, Spokane Valley, WA 99206-4612 | 2011-06-23 |
| 1205160702 | Option Care Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 5885 State Highway 303 Ne, Bremerton, WA 98311-3792 | 2009-09-30 |
| 1184958654 | Option Care Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 6111 Lakewood Towne Center Blvd Sw, Suite L, Lakewood, WA 98499-6517 | 2009-09-30 |
| 1922248749 | Cascade Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 3601 Se Columbia Way, Suite 190, Vancouver, WA 98661-8056 | 2009-03-06 |
| 1356509681 | The Specialty Care Shop | Durable Medical Equipment & Medical Supplies | 1620 S Taverner Dr, Ridgefield, WA 98642-7802 | 2008-05-22 |
| 1952580953 | Pacific Coast Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 8080 E Mill Plain Blvd, Vancouver, WA 98664-2002 | 2007-10-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on OPTION 1 NORTHWEST ENTERAL LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.