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NPI Code Detail

MEDICARE: WESTERN HOME CARE, LLC

MEDICARE: WESTERN HOME CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336H0001XHome Infusion Therapy PharmacyPH02658NV
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)PH02658NV
3332B00000XDurable Medical Equipment & Medical Supplies
4332BX2000XOxygen Equipment & Supplies (DME)MP00196NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407814064
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN HOME CARE, LLC
Provider Business Mailing Address
First Line : 1626 S EDWARD DR
Second Line :
City : TEMPE
State : AZ
Zip : 85281-6200
Country : US
Telephone Number : 602-252-5000
Fax Number : 602-323-5070
Provider Business Practice Location Address
First Line : 4035 E POST RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3992
Country : US
Telephone Number : 702-914-7337
Fax Number : 702-914-7304
Authorized Official
Title or Position : COO
Name : MR. JASON ALLEN SMIDT
Credential :
Telephone Number : 602-252-5000
Provider Enumeration Date : 05/03/2006
Last Update Date : 12/01/2010

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Directions to “WESTERN HOME CARE, LLC ” Practice Location

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