Healthcare Provider Details

I. General information

NPI: 1912448945
Provider Name (Legal Business Name): INFUSERX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 E MILLSAP RD STE 3
FAYETTEVILLE AR
72703-6289
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006
US

V. Phone/Fax

Practice location:
  • Phone: 479-935-4949
  • Fax: 479-445-6032
Mailing address:
  • Phone: 870-347-2534
  • Fax: 870-347-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateAR

VIII. Authorized Official

Name: TALMAGE WHITEHEAD
Title or Position: CFO
Credential:
Phone: 870-347-2534