Healthcare Provider Details

I. General information

NPI: 1508869694
Provider Name (Legal Business Name): I V SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 N MAIN ST
OLD FORGE PA
18518-1726
US

IV. Provider business mailing address

162 N MAIN ST
OLD FORGE PA
18518-1726
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-9201
  • Fax: 570-457-0465
Mailing address:
  • Phone: 570-457-9201
  • Fax: 570-457-0465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPP414691L
License Number StatePA

VIII. Authorized Official

Name: JAMES POTELUNAS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 570-457-9201