Healthcare Provider Details

I. General information

NPI: 1144670514
Provider Name (Legal Business Name): IV CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 CHESTERFIELD INDUSTRIAL BLVD
CHESTERFIELD MO
63005-1201
US

IV. Provider business mailing address

3325 BARTLETT BLVD
ORLANDO FL
32811-6428
US

V. Phone/Fax

Practice location:
  • Phone: 618-398-8069
  • Fax: 618-398-8072
Mailing address:
  • Phone: 407-515-2070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN GRIGGS
Title or Position: CEO, PRESIDENT
Credential:
Phone: 407-206-0040