MEDICARE: PREMIER INFUSION ADVANCEMENTS, 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	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1528516119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER INFUSION ADVANCEMENTS, LLC

Provider Business Mailing Address
First Line	:	1918 FERGUS PARK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-7524
Country	:	US
Telephone Number	:	409-599-6012
Fax Number	:

Provider Business Practice Location Address
First Line	:	1918 FERGUS PARK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-7524
Country	:	US
Telephone Number	:	409-599-6012
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MRS. CYNTHIA ANN REED
Credential	:	REGISTERED NURSE
Telephone Number	:	409-599-6012

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	09/13/2016

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