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
7926 SW NIMBUS AVE, SUITE 8-D, BEAVERTON, OR 97008-6435
(866) 883-1188
(503) 624-6713
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
—
272405
—
OR
Enumeration date
06/13/2007
Last updated
01/27/2025
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