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NPI Code Detail

MEDICARE: 1ST AMERICA INFUSION SERVICES LLC

MEDICARE: 1ST AMERICA INFUSION SERVICES LLC
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
1261QI0500XInfusion Therapy Clinic/Center

General Provider Information

NPI Number : 1427748680
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ST AMERICA INFUSION SERVICES LLC
Provider Business Mailing Address
First Line : 212 NORTHSIDE DR
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1858
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2351 ENERGY DR STE D
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-2618
Country : US
Telephone Number : 800-482-8466
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JUDERAL HALL
Credential :
Telephone Number : 800-482-8466
Provider Enumeration Date : 05/11/2023
Last Update Date : 05/11/2023

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Directions to “1ST AMERICA INFUSION SERVICES LLC ” Practice Location

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