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General NPI Number Information
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NPI Number | 1437919107
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Entity Type | Organization
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Legal Business Name | H2OASIS INFUSION AND WELLNESS CLINIC
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 421 E 3RD ST STE 7
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City | BLOOMINGTON
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State | IN
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Zip | 47401-3674
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Country | US
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Telephone | 812-826-4492
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Fax | 888-804-5420
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Provider Business Mailing Address
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Address Line | 421 E 3RD ST STE 7
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City | BLOOMINGTON
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State | IN
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Zip | 47401-3674
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Country | US
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Telephone | 812-826-4492
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Fax | 888-804-5420
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Authorized Official
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Title or Position | NP
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Name | SHAGOOFA ZAMANI
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Credential | NP
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Telephone | 812-826-4492
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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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