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NPI Code Detail

MEDICARE: LOVE INFUSION PHARMACY LLC

MEDICARE: LOVE INFUSION PHARMACY 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
13336H0001XHome Infusion Therapy Pharmacy6579375-1704UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16579375-1704OTHERUTPHARMACY LICENSE-CLASS B
26579375-8913OTHERUTCONTROLLED SUBSTANCE

General Provider Information

NPI Number : 1477759678
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOVE INFUSION PHARMACY LLC
Provider Business Mailing Address
First Line : 1405 W 2200 S
Second Line : SUITE 201
City : SALT LAKE CITY
State : UT
Zip : 84119-1485
Country : US
Telephone Number : 801-973-0900
Fax Number : 801-973-9571
Provider Business Practice Location Address
First Line : 1405 W 2200 S
Second Line : SUITE 201
City : SALT LAKE CITY
State : UT
Zip : 84119-1485
Country : US
Telephone Number : 801-973-0900
Fax Number : 801-973-9571
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : MR. JOSHUA LOVE
Credential : PHARM.D.
Telephone Number : 801-973-0900
Provider Enumeration Date : 06/25/2007
Last Update Date : 04/11/2008

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Directions to “LOVE INFUSION PHARMACY LLC ” Practice Location

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