Healthcare Provider Details

I. General information

NPI: 1356709349
Provider Name (Legal Business Name): INFUZION HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W 45TH ST
KANSAS CITY MO
64111-3504
US

IV. Provider business mailing address

1010 W 45TH ST
KANSAS CITY MO
64111-3504
US

V. Phone/Fax

Practice location:
  • Phone: 913-492-8510
  • Fax: 913-492-8510
Mailing address:
  • Phone: 913-492-8510
  • Fax: 913-492-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number2000160872
License Number StateKS

VIII. Authorized Official

Name: CLIFTON HOLMES
Title or Position: CEO
Credential:
Phone: 303-332-6346