MEDICARE: OPTUM INFUSION SERVICES 550, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy
4	3336C0004X	Compounding Pharmacy
5	3336S0011X	Specialty Pharmacy
6	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1851501886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTUM INFUSION SERVICES 550, LLC

Provider Business Mailing Address
First Line	:	1 OPTUM CIR STE 100
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2503
Country	:	US
Telephone Number	:	800-328-5979
Fax Number	:

Provider Business Practice Location Address
First Line	:	10607 & 10611 AURORA AVENUE
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-7927
Country	:	US
Telephone Number	:	515-727-7937
Fax Number	:	515-727-7938

Authorized Official
Title or Position	:	SECRETARY
Name	:	KEVIN EUGENE BURR
Credential	:
Telephone Number	:	712-310-4701

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	12/04/2024

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