Healthcare Provider Details

I. General information

NPI: 1366501496
Provider Name (Legal Business Name): PROMPTCARE HOME INFUSION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 E BETHPAGE RD STE 200B
PLAINVIEW NY
11803-4224
US

IV. Provider business mailing address

51 BETHPAGE RD STE 200B
PLAINVIEW NY
11803-4224
US

V. Phone/Fax

Practice location:
  • Phone: 631-454-4560
  • Fax: 631-454-4553
Mailing address:
  • Phone: 631-454-4560
  • Fax: 631-454-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number028069
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2068698
Identifier TypeOTHER
Identifier State
Identifier IssuerPK
# 2
Identifier2885578
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: STEPHEN A LARIVIERE
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 866-776-6782