OPTUM INFUSION SERVICES 401, LLC (NPI# 1093716813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093716813 |
| Entity Type | Organization |
| Organization Name | OPTUM INFUSION SERVICES 401, LLC |
| Practice Address |
455 Reservation Rd G Marina CA 93933-3328 |
| Mailing Address |
455 Reservation Road, Suite G Marina CA 93933 |
| Practice Telephone | 8313848080 |
| Practice Fax Number | 8313848065 |
| Mailing Telephone | 8663848080 |
| Mailing Fax Number | 8442318065 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | EDWARD KRAMM (CEO) |
| Authorized Official Telephone | 8773429352 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251F00000X | Home Infusion | Agencies | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PHY 53892 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1093716813 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417209438 | Optum Infusion Services 401, LLC | Durable Medical Equipment & Medical Supplies | 4610 Northgate Blvd, Ste. 130, Sacramento, CA 95834-1122 | 2012-10-15 |
| Street Address |
455 RESERVATION RD G |
| City | MARINA |
| State | CA |
| Zip Code | 93933-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803012 | Caterina Poehner | Social Worker | 617 Bayonet Cirle, Marina, CA 93933 | 2020-08-28 |
| 1972036499 | Stephanie Blalock | Counselor | 617 Bayonet Circle, Marina, CA 93933 | 2017-04-11 |
| 1588110340 | Monique Theaker | Counselor | 299b Twelfth Street, Marina, CA 93933 | 2016-08-31 |
| 1053709220 | Mehry Khazan | Marriage & Family Therapist | 299 Twelfth Street, Marina, CA 93933 | 2014-12-22 |
| 1306241476 | Tiffany Avery | Counselor | 299 12th St Ste B, Marina, CA 93933 | 2014-10-30 |
| 1881037141 | Marilyn Anderson | Counselor | 3043 Macarthur Dr, Marina, CA 93933 | 2013-04-16 |
| 1669744280 | Leslie Penley | Dentist | 3154 Deforest Rd. Suitea, Marina, CA 93933 | 2012-01-27 |
| 1215221510 | Janet Hernandez Barajas | Social Worker | 299a 12th Street, Marina, CA 93933 | 2011-06-03 |
| 1538302740 | Sonia Cortes | Counselor | 613 Bayonet Cir., Marina, CA 93933 | 2009-04-17 |
| 1144476003 | Carolina Cortez | Counselor | 2982 Bayonet Ct, Marina, CA 93933 | 2008-08-12 |
| Find all providers in zip 93933 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447897921 | Pharmacy Home Infusion Network | Pharmacy | 900 W Glenoaks Blvd Ste G, Glendale, CA 91202-2664 | 2019-12-04 |
| 1073085007 | Kaiser Foundation Health Plan Inc | Pharmacy | 615 W Avenue L Trailer, Lancaster, CA 93534-7211 | 2019-01-02 |
| 1386155752 | Toci Health Inc | Pharmacy | 8851 Watson St Apt B, Cypress, CA 90630-2269 | 2017-10-12 |
| 1154875466 | Medquick Prescription Shoppe Inc | Pharmacy | 923 Cole Ave, Los Angeles, CA 90038-2610 | 2016-08-04 |
| 1841665973 | Biomed California, Inc | Pharmacy | 721 S Glasgow Ave., Suite C, Inglewood, CA 90301-3016 | 2015-12-01 |
| 1790158756 | Soleo Health Inc. | Pharmacy | 1324 W. Winton Ave, Hayward, CA 94545-1408 | 2015-11-12 |
| 1982013462 | Medrx Infusion Clinical Pharmacy, LLC | Pharmacy | 415 N Oak St, Inglewood, CA 90302-3314 | 2014-08-08 |
| 1669884722 | Dm Clinical Collaborations | Pharmacy | 6108 San Fernando Rd, Glendale, CA 91201-2240 | 2014-05-23 |
| 1609209352 | Santa Barbara Specialty Pharmacy LLC | Pharmacy | 4690 Carpinteria Ave Ste B, Carpinteria, CA 93013-1875 | 2013-08-16 |
| 1265773501 | Saint Paul Enterprises, Inc. | Pharmacy | 1010 E Arrow Hwy, Covina, CA 91724-1020 | 2013-03-12 |
| Find all providers with the same taxonomy | ||||
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| 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.