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General NPI Number Information
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NPI Number | 1336150424
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Entity Type | Organization
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Legal Business Name | PARK INFUSIONCARE LP
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 4007 BELLAIRE BLVD STE G
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City | HOUSTON
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State | TX
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Zip | 77025
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Country | US
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Telephone | 713-668-7275
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Fax | 866-925-5620
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Provider Business Mailing Address
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Address Line | PO BOX 40700
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City | MESA
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State | AZ
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Zip | 85274-0700
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Country | US
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Telephone | 480-446-9010
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Fax | 480-993-2033
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM KEYS
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Credential |
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Telephone | 480-446-9010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 21055
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License Number State | TX
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