OPTUM INFUSION SERVICES 308, LLC (NPI# 1982901195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982901195 |
| Entity Type | Organization |
| Organization Name | OPTUM INFUSION SERVICES 308, LLC |
| Practice Address |
2420 Comanche Rd Ne, Suite A-5 Albuquerque NM 87107-4753 |
| Mailing Address |
2420 Comanche Ne, Suite A-5 Albuquerque NM 87107 |
| Practice Telephone | 8444382398 |
| Practice Fax Number | 8448900040 |
| Mailing Telephone | 8444382398 |
| Mailing Fax Number | 8448900040 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2019-10-22 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PH00004120 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 08700761 | 05 | |
| PK | 2129285 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878859 | Optum Infusion Services 308, LLC | Durable Medical Equipment & Medical Supplies | 460 S. Benson Lane, Ste. 11-12, Chandler, AZ 85224 | 2019-12-13 |
| 1518234152 | Optum Infusion Services 308, LLC | Pharmacy | 12503 E Euclid Dr Ste 80, Centennial, CO 80111 | 2011-11-28 |
| 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 |
2420 COMANCHE RD NE, SUITE A-5 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87107-4753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
| 1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
| 1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
| 1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
| 1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
| 1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
| 1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
| 1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
| 1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
| 1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
| Find all providers in zip 87107 | ||||
| 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 |
|---|---|---|---|---|
| 1801825070 | Option Care Home Care, Inc | Pharmacy | 3810 Rutledge Rd Ne, Ste B, Albuquerque, NM 87109-5562 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619047552 | Silver Rexall Drugs Inc | Pharmacy | 1308 Silver Heights Blvd, Silver City, NM 88061-5528 | 2006-11-08 |
| 1700810959 | Corner Drug Store, Inc. | Pharmacy | 2402 W Pierce St, Suite 1a, Carlsbad, NM 88220-3537 | 2006-07-11 |
| City | ALBUQUERQUE |
| Zip Code | 87107 |
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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.