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General NPI Number Information
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NPI Number | 1487453825
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Entity Type | Organization
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Legal Business Name | PICC LINES PLUS LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2900 N MILITARY TRL STE 246
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City | BOCA RATON
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State | FL
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Zip | 33431-6362
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Country | US
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Telephone | 561-736-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 41 SPRING ST STE 103B
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City | NEW PROVIDENCE
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State | NJ
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Zip | 07974-1143
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Country | US
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Telephone | 866-776-6782
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | STEPHEN ALAN LARIVIERE
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Credential |
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Telephone | 502-676-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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