Healthcare Provider Details

I. General information

NPI: 1780942284
Provider Name (Legal Business Name): APRIA HEALTHCARE OF NEW YORK STATE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1074 PULASKI ST STE 1
RIVERHEAD NY
11901-2970
US

IV. Provider business mailing address

701 TECHNOLOGY DR STE 250
CANONSBURG PA
15317-9529
US

V. Phone/Fax

Practice location:
  • Phone: 631-727-5490
  • Fax:
Mailing address:
  • Phone: 724-873-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL STARCK
Title or Position: CEO
Credential:
Phone: 949-639-2000