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 4220 Executive Circle, Suite 62 , Fort Myers FL 33916. The organization recently has 3 registered licenses in different health care specialties including Agencies / Home Health, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty.
Optum Infusion Services 204, Inc. can be contacted via phone (239) 561-2388, or through Oberg, David John via phone (949) 988-5893.
Contact Information
Primary practice address
4220 Executive Circle, Suite 62
Fort Myers FL 33916
Phone: (239) 561-2388
Fax: (844) 830-1983
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Home Health | 251E00000X | ||
| Suppliers / Compounding Pharmacy | 3336C0004X | PH 27821 | Florida |
| Suppliers / Home Infusion Therapy Pharmacy | 3336H0001X | PH26240 | Florida |
Profile Details
| NPI number | 1588936785 |
|---|---|
| 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 | Feb 2nd, 2012 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588936785 | NPPES |
| Florida | MEDICAID | 015940200 | |
| Florida | MEDICAID | 015940201 |
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