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General NPI Number Information
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NPI Number | 1083748933
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Entity Type | Organization
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Legal Business Name | AMBULATORY INFUSION CENTERS OF AMERICA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2495 HEMBY LN SUITE A
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City | GREENVILLE
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State | NC
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Zip | 27834-3771
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Country | US
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Telephone | 252-695-6380
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Fax | 252-695-6383
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Provider Business Mailing Address
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Address Line | 2495 HEMBY LN SUITE A
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City | GREENVILLE
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State | NC
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Zip | 27834-3771
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Country | US
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Telephone | 252-695-6380
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Fax | 252-695-6383
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARCHER T BANE
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Credential |
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Telephone | 252-695-6380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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