PROVIDENCE SENIOR HOME LLC
NPI 1134520463
Health Maintenance Organization in Spokane, WA

NPI Status: Active since September 05, 2014

Contact Information

3623 W INDIAN TRAIL RD
SPOKANE, WA
ZIP 99208
Phone: (509) 710-2776

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  • Organization
  • Health Maintenance Organization
  • CLIA Number: 50D2294218
  • CLIA Cert. Type: Other - AFH
  • CLIA Exp. Date: 04-04-2028

About PROVIDENCE SENIOR HOME LLC

This page provides the complete NPI Profile along with additional information for Providence Senior Home Llc, a provider established in Spokane, Washington operating as a Health Maintenance Organization. The healthcare provider is registered in the NPI registry with number 1134520463 assigned on September 2014. The practitioner's primary taxonomy code is 302R00000X with license number A752165 (WA). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mr. Sandu Codreanu Nac (Owner/provider)

NPI
1134520463
Provider Name
PROVIDENCE SENIOR HOME LLC
Entity Type
Organization
Location Address
3623 W INDIAN TRAIL RD SPOKANE, WA 99208
Location Phone
(509) 710-2776
Mailing Address
3623 W INDIAN TRAIL RD SPOKANE, WA 99208
Mailing Phone
(509) 638-8738
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-05-2014
Last Update Date
09-05-2014
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Health Maintenance Organization

Taxonomy Code
302R00000X
Type
Managed Care Organizations
License No.
A752165
License State
WA
Taxonomy Description
(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. SANDU CODREANU NAC

Authorized Official Title
OWNER/PROVIDER
Authorized Official Phone
(509) 638-8738

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D2294218
Facility Type
Other - AFH
Certificate Effective Date
November 20, 2023
Certificate Expiration Date
April 04, 2028
Laboratory Director
SANDU CODREANU
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Providence Senior Home Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134520463, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
2
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 5 → 10 → 1 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 1 + 0 + 2 + 0 + 4 + 1 + 2 + 24 = 47

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1134520463.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Licensed Practical Nurse
3623 W INDIAN TRAIL RD
SPOKANE, WA 99208

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134520463, enumerated as an "organization" on September 05, 2014.

The provider is located at 3623 W INDIAN TRAIL RD SPOKANE, WA 99208 and the phone number is (509) 710-2776.

Health Maintenance Organization with taxonomy code 302R00000X.