=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073209524
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FLX MEDICAL INFUSION, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2023
-----------------------------------------------------
Last Update Date | 08/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 PARRISH ST STE A
-----------------------------------------------------
City | CANANDAIGUA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14424-1727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-919-6002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 PARRISH ST STE A
-----------------------------------------------------
City | CANANDAIGUA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14424-1727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-919-6002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANANGER
-----------------------------------------------------
Name | MRS. JOLENE LOUISE THORPE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-727-2542
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QI0500X
-----------------------------------------------------
Taxonomy Name | Infusion Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------