MEDICARE: OPTUM INFUSION SERVICES 553, 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	3336C0003X	Community/Retail Pharmacy
3	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1982602991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTUM INFUSION SERVICES 553, LLC

Provider Business Mailing Address
First Line	:	1 OPTUM CIR STE 100
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2503
Country	:	US
Telephone Number	:	800-328-5979
Fax Number	:

Provider Business Practice Location Address
First Line	:	6531 MERIDIEN DR STE 113
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-3213
Country	:	US
Telephone Number	:	800-465-3203
Fax Number	:	800-582-9315

Authorized Official
Title or Position	:	SECRETARY
Name	:	KEVIN EUGENE BURR
Credential	:
Telephone Number	:	712-310-4701

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	12/04/2024

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