MEDICARE: CHESAPEAKE INFUSION INC.

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	333600000X	Pharmacy	3587	TN

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841291499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESAPEAKE INFUSION INC.

Provider Business Mailing Address
First Line	:	6272 LEE VISTA BLVD
Second Line	:	LEGAL DEPT
City	:	ORLANDO
State	:	FL
Zip	:	32822-5148
Country	:	US
Telephone Number	:	888-773-7376
Fax Number	:	888-773-7386

Provider Business Practice Location Address
First Line	:	2175 BUSINESS CENTER DR
Second Line	:	SUITE 1 BUILDING C
City	:	MEMPHIS
State	:	TN
Zip	:	38134-5628
Country	:	US
Telephone Number	:	800-260-6667
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	GAYLE JOHNSTON
Credential	:
Telephone Number	:	407-854-6532

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	08/22/2020

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