MEDICARE: SPOKANE HOME CARE SERVICES, 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
1	251E00000X	Home Health Agency	HH-163	ID
2	251E00000X	Home Health Agency	IHS.FS.60214206	WA

General Provider Information

NPI Number	:	1821396284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOKANE HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-233-5764

Provider Business Practice Location Address
First Line	:	201 W NORTH RIVER DR STE 335
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2262
Country	:	US
Telephone Number	:	509-326-2300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA L PROFFITT
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	03/09/2011
Last Update Date	:	09/06/2024

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