Healthcare Provider Details

I. General information

NPI: 1114972106
Provider Name (Legal Business Name): HOME INFUSION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 MEADOWBROOK RD STE 106
BENTON HARBOR MI
49022-9609
US

IV. Provider business mailing address

PO BOX 813
SAINT JOSEPH MI
49085-0813
US

V. Phone/Fax

Practice location:
  • Phone: 269-985-4422
  • Fax: 269-982-0224
Mailing address:
  • Phone: 269-985-4422
  • Fax: 269-985-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number5301005592
License Number StateMI

VIII. Authorized Official

Name: JOSEPH EFFA
Title or Position: DIVISION DIRECTOR
Credential: RN, MBA
Phone: 269-985-4441