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General NPI Number Information
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NPI Number | 1205567039
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Entity Type | Organization
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Legal Business Name | NEW HORIZON INFUSION CLINICS, LLC
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 2633 MAHAN DR STE B
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5405
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Country | US
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Telephone | 850-906-5049
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Fax |
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Provider Business Mailing Address
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Address Line | 1639 VILLAGE SQUARE BLVD STE 2
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City | TALLAHASSEE
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State | FL
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Zip | 32309-2763
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Country | US
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Telephone | 850-933-4342
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. WILBURN TURNER DAVIS III
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Credential | RPH
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Telephone | 850-933-4342
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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