Organization
OPTION 1 NUTRITION SOLUTIONS, 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
2460 E GERMANN RD., SUITE 18, CHANDLER, AZ 85286
(480) 883-1188
(480) 883-1193
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
492009
—
AZ
Enumeration date
08/01/2006
Last updated
01/27/2025
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