OPTUM INFUSION SERVICES 308, LLC (NPI# 1245878859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245878859 |
| Entity Type | Organization |
| Organization Name | OPTUM INFUSION SERVICES 308, LLC |
| Practice Address |
460 S. Benson Lane, Ste. 11-12 Chandler AZ 85224 |
| Practice Telephone | 8887054470 |
| Practice Fax Number | 8442676202 |
| Mailing Telephone | 8887054470 |
| Mailing Fax Number | 8442676202 |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | EDWARD PAUL KRAMM (CEO) |
| Authorized Official Telephone | 9137473705 |
| Is Organization Subpart | Y |
| Parent Organization Name | SCP SPECIALTY INFUSION, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| BriovaRx Infusion Services 308, LLC | Former Legal Business Name - Organization |
| Optum Infusion Services 308, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518234152 | Optum Infusion Services 308, LLC | Pharmacy | 12503 E Euclid Dr Ste 80, Centennial, CO 80111 | 2011-11-28 |
| 1982901195 | Optum Infusion Services 308, LLC | Pharmacy | 2420 Comanche Rd Ne, Suite A-5, Albuquerque, NM 87107-4753 | 2011-02-24 |
| 1356352983 | Optum Infusion Services 308, LLC | Pharmacy | 2555 W. Fairview Street, Suite 104, Building D, Chandler, AZ 85224-4708 | 2006-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Optum Infusion Services 308, LLC | 15529 College Blvd., Lenexa, KS 66219-1351 |
| Street Address |
460 S. BENSON LANE, STE. 11-12 |
| City | CHANDLER |
| State | AZ |
| Zip Code | 85224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073172037 | Brennan Allen | Dentist | 610 N Alma School Rd Ste 4, Chandler, AZ 85224 | 2019-06-12 |
| 1518525237 | Rachel Kelly Mador-house | Genetic Counselor, MS | 685 & 695 S Dobson Rd, Chandler, AZ 85224 | 2019-05-29 |
| 1780249748 | Julia Solomon, Md | Obstetrics & Gynecology | 1725 West Frye Road, Suite 120, Chandler, AZ 85224 | 2019-05-06 |
| 1487118717 | Litonrx LLC | Pharmacy | 2080 N. Dobson Road, Suite 3, Chandler, AZ 85224 | 2019-01-31 |
| 1528556495 | Stone Med, LLC | Physical Medicine & Rehabilitation | 77 S Dobson Rd., Phoenix, AZ 85224 | 2018-04-26 |
| 1144739079 | Four Peaks Anesthesia Consultants, LLC | Anesthesiology | 1900 W Chandler Blvd Ste 15-257, Chandler, AZ 85224 | 2017-09-22 |
| 1275061350 | Whitney Carter | Behavioral Analyst | 3200 N Dobson Rd Ste F-1, Chandler, AZ 85224 | 2017-06-01 |
| 1528509171 | Angela M. Navarrete | Specialist/Technologist, Other | 1586 W Maggio Way Apt 2005, 2005, Chandler, AZ 85224 | 2017-03-15 |
| 1063958288 | Glover Family Medical, LLC | Clinic/Center | 901 S Alma School Rd, Apt. 20, Chandler, AZ 85224 | 2017-01-11 |
| 1215483748 | Stefanie Werner | Naturopath | 2075 W Warner Road, Suite 1, Chandler, AZ 85224 | 2016-08-25 |
| Find all providers in zip 85224 | ||||
| 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 |
|---|---|---|---|---|
| 1457872632 | Twelfth One, LLC | Pharmacy | 2227 W Pecos Rd Ste 12, Chandler, AZ 85224-4866 | 2017-06-28 |
| 1851577290 | Korman LLC | Pharmacy | 5783 W Erie St, Chandler, AZ 85226-2749 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750550216 | Yuma Infusion Therapy, LLC | Pharmacy | 2170 1/2 W 24th St, Yuma, AZ 85364 | 2008-02-28 |
| 1386798809 | Tucson Iv Therapy, LLC | Pharmacy | 1997 W Price St, Tucson, AZ 85705-2218 | 2007-01-22 |
| 1629029251 | Accredo Health Group Inc | Pharmacy | 2040 W Rio Salado Pkwy, Suite 101b, Tempe, AZ 85281-2802 | 2006-05-16 |
| 1801495247 | Deeflat LLC | Pharmacy | 2580 Highway 95 Ste 106, Bullhead City, AZ 86442-7324 | 2020-10-17 |
| 1952842239 | Amerita Inc | Pharmacy | 2002 N Forbes Blvd, Suite 104, Tucson, AZ 85745-1418 | 2017-03-20 |
| 1073982120 | Vitalab Pharmacy Inc | Pharmacy | 4045 E Bell Rd Ste 157, Suite 157, Phoenix, AZ 85032 | 2015-09-18 |
| 1275921082 | Banner -- University Medical Center Tucson Campus LLC | Pharmacy | 1501 N Campbell Ave, Tucson, AZ 85724-0001 | 2014-12-31 |
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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.