Healthcare Provider Details
I. General information
NPI: 1124318928
Provider Name (Legal Business Name): ABBOTT INFUSION CARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2011
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
720 S 2ND ST SUITE B
COSHOCTON OH
43812-1947
US
IV. Provider business mailing address
PO BOX 1076
COSHOCTON OH
43812-5076
US
V. Phone/Fax
- Phone: 740-295-7010
- Fax: 740-295-7020
- Phone: 740-295-7010
- Fax: 740-295-7020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BD1200X |
| Taxonomy | Dialysis Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CINDY
BRADFORD
Title or Position: PRESIDENT
Credential: MBA
Phone: 740-295-7010