Healthcare Provider Details

I. General information

NPI: 1073650768
Provider Name (Legal Business Name): I.V. SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25B MARSHELLEN DR
BEAUFORT SC
29902-6900
US

IV. Provider business mailing address

15529 COLLEGE BLVD
LENEXA KS
66219-1351
US

V. Phone/Fax

Practice location:
  • Phone: 843-524-3777
  • Fax: 843-524-3776
Mailing address:
  • Phone: 877-342-9352
  • Fax: 877-542-9352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number50005431
License Number StateSC

VIII. Authorized Official

Name: ROXANNE SMITH
Title or Position: CORPORATE COUNSEL
Credential: J.D.
Phone: 913-747-3720