Provider Demographics
NPI:1386603025
Name:INTRAMED PLUS, INC
Entity type:Organization
Organization Name:INTRAMED PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CFO/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-679-6137
Mailing Address - Street 1:775 WOODRUFF RD STE A1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3558
Mailing Address - Country:US
Mailing Address - Phone:864-281-1553
Mailing Address - Fax:864-281-1583
Practice Address - Street 1:775 WOODRUFF RD STE A1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3558
Practice Address - Country:US
Practice Address - Phone:864-281-1553
Practice Address - Fax:864-281-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC023748866000660433336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC769133OtherSC MEDICAID RX PROVIDER #
SC4224755OtherNCPDP/NABP PROVIDER #
SCDE2323Medicaid
SC0125390003Medicare NSC