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General NPI Number Information
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NPI Number | 1932237534
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Entity Type | Organization
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Legal Business Name | INFUSION SERVICES & SPECIALTY PHARMACY
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 1724 EAST BROAD ST. SUITE 136
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 817-453-5022
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Fax | 817-453-5027
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Provider Business Mailing Address
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Address Line | 1724 EAST BROAD ST. SUITE 136
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 817-453-5022
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Fax | 817-453-5027
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MS. MARSHA LYN PROCTOR
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Credential | PHAMD
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Telephone | 817-937-0159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 25430
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | 25430
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 25430
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 25430
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 25430
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 25430
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 25430
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 25430
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License Number State | TX
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