Healthcare Provider Details

I. General information

NPI: 1770634834
Provider Name (Legal Business Name): INFUSION PHARMACY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 WISCONSIN AVE
BOSCOBEL WI
53805-1532
US

IV. Provider business mailing address

1028 WISCONSIN AVE
BOSCOBEL WI
53805-1532
US

V. Phone/Fax

Practice location:
  • Phone: 608-375-4466
  • Fax: 608-375-2383
Mailing address:
  • Phone: 608-375-4466
  • Fax: 608-375-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number7127-042
License Number StateWI

VIII. Authorized Official

Name: MS. MICHELLE E FARRELL
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 608-375-4466