Healthcare Provider Details

I. General information

NPI: 1689900789
Provider Name (Legal Business Name): HOME INFUSION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 EATON PL STE 170
FAIRFAX VA
22030-2231
US

IV. Provider business mailing address

1001 GRAND ST S
HAMMONTON NJ
08037-3384
US

V. Phone/Fax

Practice location:
  • Phone: 703-273-0333
  • Fax: 703-273-0332
Mailing address:
  • Phone: 609-484-6262
  • Fax: 609-383-9117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number0201004312
License Number StateVA

VIII. Authorized Official

Name: ALEXANDER SCHOTT
Title or Position: CFO
Credential:
Phone: 609-484-6262