Provider Demographics
NPI:1003379108
Name:INFUSION EXPRESS OF TENNESSEE, PC
Entity Type:Organization
Organization Name:INFUSION EXPRESS OF TENNESSEE, PC
Other - Org Name:IVX HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIBELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-610-3727
Mailing Address - Street 1:PO BOX 7514
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-7514
Mailing Address - Country:US
Mailing Address - Phone:615-510-6002
Mailing Address - Fax:844-627-2518
Practice Address - Street 1:1006 GLENBROOK WAY
Practice Address - Street 2:STE 130
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:913-948-2020
Practice Address - Fax:844-627-2518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNNAOtherCOMMERCIAL
NAOtherNA