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General NPI Number Information
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NPI Number | 1003404609
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Entity Type | Organization
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Legal Business Name | 307 INFUSION PHARMACY, LLC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 1030 N POPLAR ST STE A
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City | CASPER
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State | WY
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Zip | 82601-1378
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Country | US
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Telephone | 307-333-1054
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 N POPLAR ST STE A
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City | CASPER
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State | WY
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Zip | 82601-1378
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Country | US
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Telephone | 307-247-1650
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CHRISTY DAVIS
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Credential | PHARMD
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Telephone | 307-333-1054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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