Healthcare Provider Details

I. General information

NPI: 1952598575
Provider Name (Legal Business Name): OPTUM INFUSION SERVICES 101, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 CONKLIN ST STE D
FARMINGDALE NY
11735-2429
US

IV. Provider business mailing address

1 OPTUM CIR STE 100
EDEN PRAIRIE MN
55344-2956
US

V. Phone/Fax

Practice location:
  • Phone: 800-346-6348
  • Fax: 866-689-3569
Mailing address:
  • Phone: 800-328-5979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DENISE MCCABE
Title or Position: SECRETARY
Credential:
Phone: 952-935-1191