Healthcare Provider Details

I. General information

NPI: 1235226465
Provider Name (Legal Business Name): INFUSION PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 MAIN STREET SUITE, 305
WALTHAM MA
02451-3613
US

IV. Provider business mailing address

36 LUNDA STREET
WALTHAM MA
02451
US

V. Phone/Fax

Practice location:
  • Phone: 617-823-8763
  • Fax: 781-899-2910
Mailing address:
  • Phone: 617-823-8763
  • Fax: 617-398-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberTTPI
License Number StateMA

VIII. Authorized Official

Name: MS. YOLANDE LOUIS
Title or Position: CEO
Credential: CRNI, MHA
Phone: 617-823-8763