Provider Demographics
NPI:1124703848
Name:IV NATIONAL LLC
Entity type:Organization
Organization Name:IV NATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKOW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:646-384-2277
Mailing Address - Street 1:61 ROCK SPRING RD
Mailing Address - Street 2:UNIT 34
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1946
Mailing Address - Country:US
Mailing Address - Phone:646-384-2277
Mailing Address - Fax:
Practice Address - Street 1:FIVE GREENTREE CENTRE 525 ROUTE 73 NORTH
Practice Address - Street 2:SUITE 104
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:646-384-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No331L00000XSuppliersBlood Bank