MEDICARE: IMPACT INFUSION CARE, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1457293656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPACT INFUSION CARE, LLC.

Provider Business Mailing Address
First Line	:	6001 WINDHAVEN PKWY STE 220
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8022
Country	:	US
Telephone Number	:	888-456-7832
Fax Number	:	726-800-4974

Provider Business Practice Location Address
First Line	:	6001 WINDHAVEN PKWY STE 220
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8022
Country	:	US
Telephone Number	:	888-456-7832
Fax Number	:	726-800-4974

Authorized Official
Title or Position	:	CEO
Name	:	CALEB CHEATHEAM
Credential	:
Telephone Number	:	210-646-4888

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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