Healthcare Provider Details

I. General information

NPI: 1659315281
Provider Name (Legal Business Name): SHARP HOME INFUSION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 WAKARUSA ST
LA MESA CA
91942-3307
US

IV. Provider business mailing address

9000 WAKARUSA ST
LA MESA CA
91942-3307
US

V. Phone/Fax

Practice location:
  • Phone: 619-740-4969
  • Fax: 619-740-4529
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY43865
License Number StateCA

VIII. Authorized Official

Name: BRUCE SCHMIDT
Title or Position: MANGER/PIC
Credential: RPH
Phone: 619-740-4455