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General NPI Number Information
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NPI Number | 1104109313
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Entity Type | Organization
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Legal Business Name | IV SERVICES LLC
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3044 RIDGELAKE DR
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City | METAIRIE
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State | LA
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Zip | 70002-4925
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Country | US
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Telephone | 504-394-9037
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Fax | 504-392-0973
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Provider Business Mailing Address
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Address Line | 3044 RIDGELAKE DR
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City | METAIRIE
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State | LA
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Zip | 70002-4925
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Country | US
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Telephone | 504-394-9037
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Fax | 504-392-0973
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Authorized Official
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Title or Position | CFO
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Name | KYLE MCCOLLUM
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Credential |
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Telephone | 949-375-6566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion 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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHY003256IR
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License Number State | LA
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