Healthcare Provider Details

I. General information

NPI: 1578718581
Provider Name (Legal Business Name): OPTUM INFUSION SERVICES 205, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E SILVER SPRINGS BLVD STE 201
OCALA FL
34470-7057
US

IV. Provider business mailing address

15529 COLLEGE BLVD.
LENEXA KS
66219-1351
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-4148
  • Fax: 855-381-5543
Mailing address:
  • Phone: 877-342-9352
  • Fax: 877-542-9352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLEY WILLIAMS
Title or Position: CONPLIANCE ANALYST/ PARALEGAL
Credential:
Phone: 913-335-6786