Organization
WESTERN HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A COSTON BILLING MANAGER (MANAGER)
(480) 246-3950
Entity
Organization
Contact information
Practice address
4035 E POST RD, LAS VEGAS, NV 89120-3992
(702) 262-5500
(702) 262-9997
Mailing address
1626 S EDWARD DR, TEMPE, AZ 85281-6200
(602) 252-5000
(602) 323-5070
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
200035-424
NV
3336H0001X
Home Infusion Therapy Pharmacy
Primary
2000035-424
NV
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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