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NPI Code Detail

MEDICARE: LIFE INFUSIONS PHARMA CORP.

MEDICARE: LIFE INFUSIONS PHARMA CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0004XCompounding Pharmacy
33336S0011XSpecialty Pharmacy
43336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1245012699
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE INFUSIONS PHARMA CORP.
Provider Business Mailing Address
First Line : 19 FAYETTE ST FL 4
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4597
Country : US
Telephone Number : 718-750-9020
Fax Number : 718-750-9021
Provider Business Practice Location Address
First Line : 19 FAYETTE ST FL 4
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4597
Country : US
Telephone Number : 718-750-9020
Fax Number : 718-750-9021
Authorized Official
Title or Position : PRESIDENT
Name : ELAN GUTTMAN
Credential : RPH
Telephone Number : 917-575-2231
Provider Enumeration Date : 10/19/2023
Last Update Date : 12/13/2024

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Directions to “LIFE INFUSIONS PHARMA CORP. ” Practice Location

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