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General NPI Number Information
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NPI Number | 1932516713
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Entity Type | Organization
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Legal Business Name | INFUSION LOGISTICS, LLC
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 332 ARDMORE AVE
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City | ARDMORE
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State | PA
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Zip | 19003-1012
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Country | US
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Telephone | 610-649-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 332 ARDMORE AVE
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City | ARDMORE
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State | PA
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Zip | 19003-1012
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Country | US
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Telephone | 610-649-3540
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN BARB
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Credential | CRNP
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Telephone | 610-649-3540
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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 | SP011731
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License Number State | PA
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