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1245951615 NPI number — KELNER SPECIALTY INFUSION SERVICES, LLC

NPI Number: 1245951615
Health Care Provider/Practitioner: KELNER SPECIALTY INFUSION SERVICES, LLC

Information about “1245951615” NPI (KELNER SPECIALTY INFUSION SERVICES, LLC) exists in 1245951615 in HTML format HTML  |  1245951615 in plain Text format TXT  |  1245951615 in PDF (Portable Document Format) PDF  |  1245951615 in an XML format XML  formats.

NPI Number : 1245951615 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245951615",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KELNER SPECIALTY INFUSION SERVICES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3304 EAGLE TRL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RALEIGH",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27615-4023",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "919-624-6533",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3200 NORTHLINE AVE STE 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENSBORO",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27408-7600",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "336-604-0256",
    "PracticeLocationAddressFaxNumber": "336-604-0257",
    "EnumerationDate": "09/06/2022",
    "LastUpdateDate": "09/06/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BONNER",
    "AuthorizedOfficialFirstName": "VANETTA",
    "AuthorizedOfficialMiddleName": "COX",
    "AuthorizedOfficialTitle": "DNP",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "202-725-8603",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251F00000X",
          "TaxonomyName": "Home Infusion Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332BP3500X",
          "TaxonomyName": "Parenteral & Enteral Nutrition Supplies (DME)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "333600000X",
          "TaxonomyName": "Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336H0001X",
          "TaxonomyName": "Home Infusion Therapy Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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