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General NPI Number Information
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NPI Number | 1609908284
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Entity Type | Organization
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Legal Business Name | NUTRISHARE, LLC
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 11020 PLANTSIDE DR
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City | LOUISVILLE
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State | KY
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Zip | 40299-6105
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Country | US
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Telephone | 502-297-0222
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Fax | 916-478-7924
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Provider Business Mailing Address
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Address Line | 9850 KENT ST
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City | ELK GROVE
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State | CA
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Zip | 95624-9483
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Country | US
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Telephone | 916-685-5034
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Fax | 916-478-7924
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Authorized Official
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Title or Position | PRESIDENT
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Name | AUSTIN PULSIPHER
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Credential |
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Telephone | 916-478-7811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | P06292
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License Number State | KY
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Taxonomy #2
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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 | KY
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