Organization
WESTERN HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON ALLEN SMIDT (COO)
(602) 252-5000
Entity
Organization
Contact information
Practice address
4035 E POST RD, LAS VEGAS, NV 89120-3992
(702) 914-7337
(702) 914-7304
Mailing address
1626 S EDWARD DR, TEMPE, AZ 85281-6200
(602) 252-5000
(602) 323-5070
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PH02658
NV
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MP00196
NV
3336H0001X
Home Infusion Therapy Pharmacy
PH02658
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504717
—
NV
Enumeration date
05/03/2006
Last updated
12/01/2010
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