1255396842 NPI number — ALL MED INFUSION, INC.

Table of content: (NPI 1255396842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255396842 NPI number — ALL MED INFUSION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL MED INFUSION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255396842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3102 CHERRY PALM DR
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33619-8314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-620-3773
Provider Business Mailing Address Fax Number:
813-620-3547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3102 CHERRY PALM DR
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33619-8314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-620-3773
Provider Business Practice Location Address Fax Number:
813-620-3547
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CUCUZ
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
813-620-3773

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  PH 13923 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BP3500X , with the licence number: PH 13923 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336H0001X , with the licence number: PH 13923 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: PH 13923 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336S0011X , with the licence number: PH 13923 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P7152 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1087180 . This is a "NABP/NCPDP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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