Healthcare Provider Details

I. General information

NPI: 1881923738
Provider Name (Legal Business Name): INFUSION RESOURCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 FAUNCE CORNER ROAD SUITE #610
N. DARTMOUTH MA
02747
US

IV. Provider business mailing address

74 FAUNCE CORNER ROAD SUITE #610
N. DARTMOUTH MA
02747
US

V. Phone/Fax

Practice location:
  • Phone: 774-992-7068
  • Fax: 774-992-7069
Mailing address:
  • Phone: 774-992-7068
  • Fax: 774-992-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateMA

VIII. Authorized Official

Name: MARIAN MARCOCCIO
Title or Position: VP OPERATIONS
Credential:
Phone: 774-992-7068