Healthcare Provider Details
I. General information
NPI: 1245206697
Provider Name (Legal Business Name): SPECTRUM INFUSION, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2006
Last Update Date: 03/07/2023
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3221 BLUE RIDGE RD SUITE 101
RALEIGH NC
27612-8063
US
IV. Provider business mailing address
3221 BLUE RIDGE RD SUITE 101
RALEIGH NC
27612-8063
US
V. Phone/Fax
- Phone: 919-781-2241
- Fax: 919-781-7060
- Phone: 919-781-2241
- Fax: 919-781-7060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 6231 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
ALAN
W
KNIGHT
Title or Position: PRESIDENT
Credential: RPH
Phone: 919-781-2241