Optum Infusion Services 204, Inc.

LBN: Optum Infusion Services 204, Inc.
Optum Infusion Services 204, Inc. is an health care organization with primary practice located at 826 Creighton Rd Unit A103, Pensacola FL 32504-7076. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Managed Care Organization Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Optum Infusion Services 204, Inc. can be contacted via phone (866) 522-8438, or through Oberg, David John via phone (949) 988-5893.

Contact Information

Primary practice address
826 Creighton Rd Unit A103 Pensacola FL 32504-7076
Phone: (866) 522-8438
Fax: (844) 246-1271
Website:
Map and Directions
Authorized official contact:
Name: Oberg, David John
Phone: (949) 988-5893

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Compounding Pharmacy 3336C0004X PH27820 Florida
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X PH22890 Florida
Suppliers / Managed Care Organization Pharmacy 3336M0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1356538771
LBN Legal business name Optum Infusion Services 204, Inc.
DBA Doing business as
Authorized official Oberg, David John
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2007
Last updated Dec 29th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356538771 NPPES
Florida MEDICAID 016048600
Florida Other 1029215

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