Healthcare Provider Details

I. General information

NPI: 1477647337
Provider Name (Legal Business Name): PROMPTCARE HOME INFUSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 SPRING ST STE 103B
NEW PROVIDENCE NJ
07974-1143
US

IV. Provider business mailing address

41 SPRING ST STE 103B
NEW PROVIDENCE NJ
07974-1143
US

V. Phone/Fax

Practice location:
  • Phone: 866-526-1297
  • Fax: 855-454-4553
Mailing address:
  • Phone: 866-526-1297
  • Fax: 855-454-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number28RS00545700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number28RS00545700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number28RS00545700
License Number StateNJ
# 6
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number28RS00545700
License Number StateNJ

VIII. Authorized Official

Name: STEPHEN A LARIVIERE
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 866-776-6782