BROOKS HOME I.V., INC. (BROOKS HEALTH CARE) - NPI NUMBER 1760417232

Summary

Provider Name: BROOKS HOME I.V., INC. (BROOKS HEALTH CARE)

NPI Number: 1760417232

Clasification: Clinic/Center (261QI0500X)

Specialization: Infusion Therapy

Address:
3410 W ASHLAN AVE
FRESNO, CA
ZIP 93722

Phone Number: (559) 221-4800



Detailed Information

BROOKS HOME I.V., INC. is an infusion therapy clinic/center in Fresno, CA. The assigned NPI number for this provider is 1760417232 and is registered as an organization entity type.
The provider Is Doing Business As Brooks Health Care.

The provider's business address is:

3410 W ASHLAN AVE
FRESNO, CA
ZIP 93722-440
Phone: (559) 221-4800
Fax: (559) 233-0227

The provider's authorized official is Kelly John Brooks .
The authorized official title is C.e.o. and has the following contact phone number (559) 221-4800.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 11/19/2009.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1568526697 THE INFUSION CENTER, INC.
Clinic/Center (Infusion Therapy)
1063519858 GETTYSBURG MEDICAL CLINIC, INC.
Clinic/Center (Multi-Specialty)
1043341597 COUNTY OF FRESNO
Clinic/Center
1063535557 WESTCARE CALIFORNIA
Clinic/Center (Rehabilitation, Substance Use Disorder)
1043399090 FIRST CHOICE PHYSICAL THERAPY &REHAB, INC
Clinic/Center (Physical Therapy)
1003031022 ST AGNES OCCUPATIONAL HEALTH CENTER
Clinic/Center (Occupational Medicine)
1144451659 HIPOLITO G. MARIANO, JR., MD, INC.
Clinic/Center (Primary Care)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QI0500X Clinic/Center Infusion Therapy PHY43496 CA No
2 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies 101409 CA No
3 3336H0001X Pharmacy Home Infusion Therapy Pharmacy PHY43496 CA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 PHA434960 MEDICAID CA
2 1218850001 MEDICARE NSC CA

NPI Record

No. Field Name Field Value
1 NPI 1760417232
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name BROOKS HOME I.V., INC.
5 Provider Other Organization Name BROOKS HEALTH CARE
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 3410 W ASHLAN AVE
8 Provider Business Practice Location Address City Name FRESNO
9 Provider Business Practice Location Address State Name CA
10 Provider Business Practice Location Address Postal Code 937224440
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 5592214800
13 Provider Business Practice Location Address Fax Number 5592330227
14 Provider Enumeration Date 7/12/2006
15 Last Update Date 11/19/2009
16 Authorized Official Last Name BROOKS
17 Authorized Official First Name KELLY
18 Authorized Official Middle Name JOHN
19 Authorized Official Title or Position C.E.O.
20 Authorized Official Telephone Number 5592214800
21 Healthcare Provider Taxonomy Code 1 261QI0500X
22 Provider License Number 1 PHY43496
23 Provider License Number State Code 1 CA
24 Healthcare Provider Primary Taxonomy Switch 1 N
25 Healthcare Provider Taxonomy Code 2 332BX2000X
26 Provider License Number 2 101409
27 Provider License Number State Code 2 CA
28 Healthcare Provider Primary Taxonomy Switch 2 N
29 Healthcare Provider Taxonomy Code 3 3336H0001X
30 Provider License Number 3 PHY43496
31 Provider License Number State Code 3 CA
32 Healthcare Provider Primary Taxonomy Switch 3 Y
33 Other Provider Identifier 1 PHA434960
34 Other Provider Identifier Type Code 1 05
35 Other Provider Identifier State 1 CA
36 Other Provider Identifier 2 1218850001
37 Other Provider Identifier Type Code 2 07
38 Other Provider Identifier State 2 CA
39 Is Organization Subpart N
40 Authorized Official Name Prefix Text DR.
41 Authorized Official Credential Text PHARM D

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.