Provider Demographics
NPI:1528148665
Name:ADVANCED INFUSION THERAPEUTICS, LLC
Entity type:Organization
Organization Name:ADVANCED INFUSION THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-622-2700
Mailing Address - Street 1:5401 S SHERIDAN RD
Mailing Address - Street 2:STE 202
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-7531
Mailing Address - Country:US
Mailing Address - Phone:918-622-2700
Mailing Address - Fax:918-622-2701
Practice Address - Street 1:5401 S SHERIDAN RD
Practice Address - Street 2:STE 202
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-7531
Practice Address - Country:US
Practice Address - Phone:918-622-2700
Practice Address - Fax:918-622-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2-46083336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherHEALTHCHOICE PROVIDER NUM