MEDICARE: ENCORE INFUSION MANAGEMENT, 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1467105593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE INFUSION MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	PO BOX 32789
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33420-2789
Country	:	US
Telephone Number	:	561-327-4970
Fax Number	:	561-823-0829

Provider Business Practice Location Address
First Line	:	9943 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6923
Country	:	US
Telephone Number	:	513-313-9014
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS DEVELOPMENT
Name	:	STACEY SHELTON
Credential	:
Telephone Number	:	513-313-9014

Provider Enumeration Date	:	01/29/2022
Last Update Date	:	02/24/2023

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