1558439745 NPI number — INFUSCIENCE, LLC

Table of content: (NPI 1558439745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558439745 NPI number — INFUSCIENCE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INFUSCIENCE, LLC
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:
6
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:
1558439745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4222 PAYSPHERE CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-0042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-879-6137
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4151 LAFAYETTE CENTER DR STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANTILLY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-230-4638
Provider Business Practice Location Address Fax Number:
703-203-4639
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHAPIRO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CFO
Authorized Official Telephone Number:
800-879-6137

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QI0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0399285000 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4839950 . This is a "NCPDP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0201004140 . This is a "LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: MO0559976 . This is a "LICENSE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0202205354 . This is a "PHARMACY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P06081 . This is a "LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 017570600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01759940 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1558439745 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: NRX1000170 . This is a "LICENSE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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