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NPI Code Detail

MEDICARE: IV THERAPY, PHLEBOTOMY, SPECIMEN COLLECTION SERVICES, LLC

MEDICARE: IV THERAPY, PHLEBOTOMY, SPECIMEN COLLECTION SERVICES, 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
1251F00000XHome Infusion Agency
2174200000XMeals Provider
3253Z00000XIn Home Supportive Care Agency
4261QI0500XInfusion Therapy Clinic/Center
5310400000XAssisted Living Facility
6331L00000XBlood Bank
7332BX2000XOxygen Equipment & Supplies (DME)
8332U00000XHome Delivered Meals
9343900000XNon-emergency Medical Transport (VAN)
10347C00000XPrivate Vehicle
11246RP1900XPhlebotomy Technician

General Provider Information

NPI Number : 1932707619
Entity Type Code : Organization
Provider Name (Legal Business Name) : IV THERAPY, PHLEBOTOMY, SPECIMEN COLLECTION SERVICES, LLC
Provider Business Mailing Address
First Line : 3845 CYPRESS CREEK PKWY STE 252
Second Line :
City : HOUSTON
State : TX
Zip : 77068-3575
Country : US
Telephone Number : 214-293-7388
Fax Number :
Provider Business Practice Location Address
First Line : 3845 CYPRESS CREEK PKWY STE 252
Second Line :
City : HOUSTON
State : TX
Zip : 77068-3575
Country : US
Telephone Number : 214-293-7388
Fax Number :
Authorized Official
Title or Position : OWNER
Name : PEARL N MILLER
Credential :
Telephone Number : 214-293-7388
Provider Enumeration Date : 10/14/2020
Last Update Date : 10/22/2020

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