Healthcare Provider Details

I. General information

NPI: 1104338482
Provider Name (Legal Business Name): INFUSE FIRST HEALTH CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 FLINT PARC CIR
BESSEMER AL
35022-6157
US

IV. Provider business mailing address

512 FLINT PARC CIR
BESSEMER AL
35022-6157
US

V. Phone/Fax

Practice location:
  • Phone: 855-635-6508
  • Fax: 205-428-8480
Mailing address:
  • Phone: 855-635-6508
  • Fax: 205-428-8480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1-147465
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number1-147475
License Number StateAL

VIII. Authorized Official

Name: KELLI T VILA-ROSA
Title or Position: OWNER
Credential: RN
Phone: 855-635-6508