OPTUM INFUSION SERVICES 302, LLC


Address: 8720 South 114th Street, Suite 106, La Vista, NE 68128
Phone: 8552953154

OPTUM INFUSION SERVICES 302, LLC (NPI# 1245564012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245564012
Entity Type Organization
Organization Name OPTUM INFUSION SERVICES 302, LLC
Practice Address 8720 South 114th Street, Suite 106
La Vista
NE 68128
Practice Telephone 8552953154
Practice Fax Number 8442048056
Mailing Telephone 8552953154
Mailing Fax Number 8442048056
Enumeration Date 2009-09-28
Last Update Date 2019-10-08
Authorized Official Name EDWARD KRAMM (CEO)
Authorized Official Telephone 8773429352
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 3336C0004X Pharmacy
Specialization: Compounding Pharmacy
Suppliers
N 3336S0011X Pharmacy
Specialization: Specialty Pharmacy
Suppliers
Y 3336H0001X Pharmacy
Specialization: Home Infusion Therapy Pharmacy
3095 NE Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NE 10025826900 05
NCPDP PROVIDER IDENTIFICATION NUMBER 2817863 01

Other Provider/Organization Names

Other Name Type Code
AxelaCare Doing Business As Name - Organization

Office Location

Street Address 8720 SOUTH 114TH STREET, SUITE 106
City LA VISTA
State NE
Zip Code 68128

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922589746 Ruth Ann Moses Prevention Professional 7030 S 110th St, Omaha, NE 68128 2018-08-29
1972945897 Jenna Leigh Graeve Physical Therapist 7040 S 114th St Plz Apt 203, La Vista, NE 68128 2013-07-19
1730385709 Granville Assisted Living, LLC Point of Service 5807 Granville Parkway, La Vista, NE 68128 2007-06-26
1629160072 Rachel L. Mccann Pediatrics 9801 Giles Road, Suite 1, La Vista, NE 68128 2006-09-29
1730118233 Donald R Krysl Optometrist 8102 S 84th St, Lavista, NE 68128 2006-06-30
1073030607 September Leigh Wanzenried Family Medicine 6901 S 84th St, La Vista, NE 68128 2017-08-24
1518312719 Costco Wholesale Corporation Eyewear Supplier (Equipment, not the service) 12515 Portside Pkwy, La Vista, NE 68128 2016-04-26
1245685445 Costco Wholesale Corporation Hearing Aid Equipment 12515 Portside Pkwy, La Vista, NE 68128 2016-04-26
1386011971 Kelsey Klatt Occupational Therapist 6960 S 110th St, La Vista, NE 68128 2015-08-31
1003299827 Jordan Tichenor Internal Medicine 8604 Giles Rd, La Vista, NE 68128 2015-06-30
Find all providers in zip 68128

Taxonomy Information

Taxonomy Code 3336H0001X
Grouping Suppliers
Classification Pharmacy
Specialization Home Infusion Therapy Pharmacy

Taxonomy Definition

Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance.
Notes: Source: National Home Infusion Association [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1063956571 Greater Nebraska Home Infusion Inc Pharmacy 2604 Saint Patrick Ave Ste 2, Grand Island, NE 68803-1313 2016-12-19
1922043603 Good Samaritan Hospital Pharmacy 2501 30th Ave, Kearney, NE 68845-4017 2006-06-18
1043642473 Chi National Home Care Pharmacy 5428 F St, Omaha, NE 68117-2815 2013-08-08

Competitor

Search similar providers

City LA VISTA
Zip Code 68128

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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