Healthcare Provider Details

I. General information

NPI: 1497111272
Provider Name (Legal Business Name): HOWLAND INFUSION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 E MARKET ST SUITE #10
WARREN OH
44484-2375
US

IV. Provider business mailing address

8600 E MARKET ST SUITE #10
WARREN OH
44484-2375
US

V. Phone/Fax

Practice location:
  • Phone: 330-469-6120
  • Fax: 330-469-5247
Mailing address:
  • Phone: 330-469-6120
  • Fax: 330-469-5247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPMY.022590050-0
License Number StateOH

VIII. Authorized Official

Name: CARL FOSSACECA
Title or Position: OWNER
Credential:
Phone: 330-469-6120