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General NPI Number Information
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NPI Number | 1972630168
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Entity Type | Organization
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Legal Business Name | OPTIMED INFUSION LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 8080 RAVINES EDGE CT STE 200
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City | COLUMBUS
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State | OH
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Zip | 43235-5424
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Country | US
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Telephone | 614-430-8022
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Fax | 614-430-8025
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Provider Business Mailing Address
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Address Line | 8080 RAVINES EDGE CT STE 200
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City | COLUMBUS
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State | OH
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Zip | 43235-5424
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Country | US
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Telephone | 614-430-8022
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Fax | 614-430-8025
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD L MCNEIL
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Credential | MD
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Telephone | 614-430-8022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35054381
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License Number State | OH
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