Provider Demographics
NPI:1497797278
Name:QUALITY HOME INFUSION
Entity Type:Organization
Organization Name:QUALITY HOME INFUSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:OHARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-429-0881
Mailing Address - Street 1:2321 W OLIVE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2321 W OLIVE AVE STE D
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2603
Practice Address - Country:US
Practice Address - Phone:818-848-8112
Practice Address - Fax:818-848-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY472453336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5617406OtherOTHER ID NUMBER
5617406OtherOTHER ID NUMBER-COMMERCIAL NUMBER