Healthcare Provider Details

I. General information

NPI: 1295703403
Provider Name (Legal Business Name): AMERICAN INFUSION MIDATLANTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 US HIGHWAY 46 # C
FAIRFIELD NJ
07004-2437
US

IV. Provider business mailing address

353 US HIGHWAY 46 # C
FAIRFIELD NJ
07004-2437
US

V. Phone/Fax

Practice location:
  • Phone: 800-466-3487
  • Fax: 973-882-5090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRS00659000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONALD CARLBERG
Title or Position: CEO
Credential:
Phone: 800-466-3487