Provider Demographics
NPI:1063406247
Name:ACCESS INFUSION PARTNERS, LLP
Entity type:Organization
Organization Name:ACCESS INFUSION PARTNERS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-275-2050
Mailing Address - Street 1:11220 METRO PKWY
Mailing Address - Street 2:SUITE 31
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1291
Mailing Address - Country:US
Mailing Address - Phone:239-275-2050
Mailing Address - Fax:239-275-6931
Practice Address - Street 1:11220 METRO PKWY
Practice Address - Street 2:SUITE 31
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1291
Practice Address - Country:US
Practice Address - Phone:239-275-2050
Practice Address - Fax:239-275-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH15572333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106329400Medicaid
FL106329401Medicaid
FL106329400Medicaid