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General NPI Number Information
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NPI Number | 1477571404
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Entity Type | Organization
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Legal Business Name | CYSTIC FIBROSIS SERVICES LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 10530 JOHN W ELLIOTT DR STE 200
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City | FRISCO
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State | TX
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Zip | 75033
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Country | US
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Telephone | 800-541-4959
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Fax | 866-574-1418
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Provider Business Mailing Address
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Address Line | 1901 E VOORHEES ST MS 790
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City | DANVILLE
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State | IL
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Zip | 61834-4509
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Country | US
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Telephone | 217-709-2386
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Fax | 217-709-2344
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Authorized Official
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Title or Position | MANAGER
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Name | JENNIFER PONCE
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Credential |
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Telephone | 847-527-2489
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 22618
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 22618
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 29801
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License Number State | TX
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