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General NPI Number Information
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NPI Number | 1518028604
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Entity Type | Organization
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Legal Business Name | INTRAVENE, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 2215 LANDOVER PL
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City | LYNCHBURG
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State | VA
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Zip | 24501-2115
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Country | US
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Telephone | 434-947-3900
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Fax | 434-544-2332
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Provider Business Mailing Address
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Address Line | 2215 LANDOVER PL
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City | LYNCHBURG
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State | VA
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Zip | 24501-2115
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Country | US
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Telephone | 434-947-3900
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Fax | 434-544-2332
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. NANCY DAVIS MOORE
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Credential |
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Telephone | 434-947-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201002819
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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