Healthcare Provider Details

I. General information

NPI: 1902263825
Provider Name (Legal Business Name): OAKSTEAD INFUSION PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2016
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 W ANTELOPE DR SUITE 208
LAYTON UT
84041-1139
US

IV. Provider business mailing address

1492 W ANTELOPE DR SUITE 208
LAYTON UT
84041-1139
US

V. Phone/Fax

Practice location:
  • Phone: 801-825-3879
  • Fax: 801-991-6924
Mailing address:
  • Phone: 801-825-3879
  • Fax: 801-991-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateUT

VIII. Authorized Official

Name: ROBERT P GALERIA
Title or Position: OWNER
Credential:
Phone: 801-825-3879