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General NPI Number Information
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NPI Number | 1942391271
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Entity Type | Organization
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Legal Business Name | OPTUM INFUSION SERVICES 201, INC.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 5700 DOT COM, SUITE 1050
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City | OVIEDO
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State | FL
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Zip | 32765
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Country | US
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Telephone | 888-999-8586
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Fax | 844-830-2088
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Provider Business Mailing Address
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Address Line | 5700 DOT COM, SUITE 1050
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City | OVIEDO
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State | FL
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Zip | 32765
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Country | US
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Telephone | 888-999-8586
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Fax | 844-830-2088
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Authorized Official
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Title or Position | SECRETARY
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Name | KEVIN EUGENE BURR
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Credential |
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Telephone | 712-310-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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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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