MEDICARE: HOME INFUSION SOLUTIONS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336S0011X	Specialty Pharmacy
3	3336H0001X	Home Infusion Therapy Pharmacy	0201004386	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2130243	OTHER		PK

General Provider Information

NPI Number	:	1548552466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME INFUSION SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1001 GRAND ST S
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-3384
Country	:	US
Telephone Number	:	609-484-6262
Fax Number	:	609-383-9117

Provider Business Practice Location Address
First Line	:	8701 PARK CENTRAL DR STE 600
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-1152
Country	:	US
Telephone Number	:	804-767-3600
Fax Number	:	804-767-3606

Authorized Official
Title or Position	:	CFO
Name	:	ALEXANDER SCHOTT
Credential	:
Telephone Number	:	609-484-6262

Provider Enumeration Date	:	05/11/2011
Last Update Date	:	04/09/2015

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