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General NPI Number Information
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NPI Number | 1417679622
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Entity Type | Organization
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Legal Business Name | ADVANCED INFUSION SERVICES, LLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 4020 21ST ST STE 3
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City | LUBBOCK
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State | TX
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Zip | 79410-1126
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Country | US
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Telephone | 806-696-8010
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Fax | 806-696-8020
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Provider Business Mailing Address
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Address Line | 4020 21ST ST STE 3
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City | LUBBOCK
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State | TX
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Zip | 79410-1126
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Country | US
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Telephone | 806-696-8010
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Fax | 806-696-8020
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ADAM BEAM
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Credential |
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Telephone | 806-696-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 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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