Organization
OPTION 1 NORTHWEST ENTERAL LLC
Active
Other names
Aveanna Healthcare Medical Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
8633 SOUTH 212TH STREET, KENT, WA 98031
(888) 885-2386
(888) 599-3448
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9058462
—
WA
05
—
9058470-02
—
WA
Enumeration date
11/02/2006
Last updated
01/27/2025
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