Healthcare Provider Details

I. General information

NPI: 1073614103
Provider Name (Legal Business Name): INFUSION SOLUTIONS OF DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 FORREST AVE
DOVER DE
19904-3309
US

IV. Provider business mailing address

1100 FORREST AVE
DOVER DE
19904-3309
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4627
  • Fax: 302-674-4628
Mailing address:
  • Phone: 302-674-4627
  • Fax: 302-674-4628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC10003264
License Number StateDE

VIII. Authorized Official

Name: MR. CHRISTOPHER MICHAEL MILLER
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 302-674-4627