MEDICARE: OPTIMED INFUSION 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	174400000X	Specialist	35054381	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1134199300	OTHER	OH	NPI

General Provider Information

NPI Number	:	1972630168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMED INFUSION LLC

Provider Business Mailing Address
First Line	:	8080 RAVINES EDGE CT
Second Line	:	STE 200
City	:	COLUMBUS
State	:	OH
Zip	:	43235-5424
Country	:	US
Telephone Number	:	614-430-8022
Fax Number	:	614-430-8025

Provider Business Practice Location Address
First Line	:	8080 RAVINES EDGE CT
Second Line	:	STE 200
City	:	COLUMBUS
State	:	OH
Zip	:	43235-5424
Country	:	US
Telephone Number	:	614-430-8022
Fax Number	:	614-430-8025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD L MCNEIL
Credential	:	MD
Telephone Number	:	614-430-8022

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	09/25/2012

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Directions to “OPTIMED INFUSION LLC ” Practice Location

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