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General NPI Number Information
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NPI Number | 1720796402
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Entity Type | Organization
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Legal Business Name | BIOCARE INFUSION, LLC
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 371 E PACES FERRY RD NE STE 125
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City | ATLANTA
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State | GA
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Zip | 30305-2372
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Country | US
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Telephone | 508-315-2769
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Fax |
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Provider Business Mailing Address
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Address Line | 371 E PACES FERRY RD NE STE 100
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City | ATLANTA
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State | GA
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Zip | 30305-3292
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Country | US
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Telephone | 470-377-6400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KINGSLEY IWUDIBIA
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Credential | PHARMD
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Telephone | 508-315-2769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 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 #4
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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 #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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