Provider Demographics
NPI:1033424486
Name:INFUSIONS,LLC
Entity Type:Organization
Organization Name:INFUSIONS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-332-1153
Mailing Address - Street 1:1313 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-3245
Mailing Address - Country:US
Mailing Address - Phone:662-332-1153
Mailing Address - Fax:
Practice Address - Street 1:1313 E UNION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-3245
Practice Address - Country:US
Practice Address - Phone:662-332-1153
Practice Address - Fax:662-332-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center