Provider Demographics
NPI:1558439745
Name:INFUSCIENCE, LLC
Entity type:Organization
Organization Name:INFUSCIENCE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CFO
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:800-879-6137
Mailing Address - Street 1:4222 PAYSPHERE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0042
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:
Practice Address - Street 1:4151 LAFAYETTE CENTER DR STE 600
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151
Practice Address - Country:US
Practice Address - Phone:703-230-4638
Practice Address - Fax:703-203-4639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INFUSCIENCE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-04
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251F00000X, 261QI0500X, 332B00000X, 333600000X, 3336C0004X, 3336H0001X, 3336M0002X
VA332BP3500X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0399285000Medicaid
VA4839950OtherNCPDP
VA0201004140OtherLICENSE
WVMO0559976OtherLICENSE
VA0202205354OtherPHARMACY
MDP06081OtherLICENSE
MD017570600Medicaid
MD01759940Medicaid
VA1558439745Medicaid
DCNRX1000170OtherLICENSE
DCNRX1000170OtherLICENSE
MD01759940Medicaid