Healthcare Provider Details

I. General information

NPI: 1295205474
Provider Name (Legal Business Name): PARAGON INFUSION THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 DERR RD STE D
SPRINGFIELD OH
45503-2439
US

IV. Provider business mailing address

2355 DERR RD STE D
SPRINGFIELD OH
45503-2439
US

V. Phone/Fax

Practice location:
  • Phone: 866-346-9866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AARON M BRADEN
Title or Position: PRESIDENT
Credential:
Phone: 866-346-9866