Healthcare Provider Details

I. General information

NPI: 1346202496
Provider Name (Legal Business Name): SPOKANE HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 W 1ST AVE
SPOKANE WA
99201-4113
US

IV. Provider business mailing address

1309 W 1ST AVE
SPOKANE WA
99201-4113
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-0200
  • Fax: 509-624-5420
Mailing address:
  • Phone: 509-456-0200
  • Fax: 509-624-5420

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. WAYNE SETZER
Title or Position: OWNER
Credential:
Phone: 509-456-0200