MEDICARE: HOME INFUSION RICHMOND, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	3336H0001X	Home Infusion Therapy Pharmacy

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7855650001	OTHER	VA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265055883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME INFUSION RICHMOND, LLC

Provider Business Mailing Address
First Line	:	9323 MIDLOTHIAN TPKE STE S
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9323 MIDLOTHIAN TPKE STE S
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-554-1500
Fax Number	:	804-510-2244

Authorized Official
Title or Position	:	OWNER/PIC
Name	:	STEFAN D DEBSKI
Credential	:
Telephone Number	:	804-554-1500

Provider Enumeration Date	:	05/19/2020
Last Update Date	:	11/25/2020

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Directions to “HOME INFUSION RICHMOND, LLC ” Practice Location

Language	Start Address	Practice Location

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