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General NPI Number Information
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NPI Number | 1396149902
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Entity Type | Organization
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Legal Business Name | 911 BIOCARE
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 316 BROOKSIDE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-4608
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Country | US
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Telephone | 855-901-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 316 BROOKSIDE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-4608
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Country | US
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Telephone | 855-901-0911
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BARBARA BARTEL
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Credential |
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Telephone | 909-816-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | G37096
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | G37096
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License Number State | CA
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