Provider Demographics
NPI:1083473243
Name:INFUSE IV THERAPY LLC
Entity Type:Organization
Organization Name:INFUSE IV THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GENISE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BARTEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:816-529-2361
Mailing Address - Street 1:6119 BLUE RIDGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4105
Mailing Address - Country:US
Mailing Address - Phone:913-347-3806
Mailing Address - Fax:816-256-5963
Practice Address - Street 1:6119 BLUE RIDGE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4105
Practice Address - Country:US
Practice Address - Phone:913-347-3806
Practice Address - Fax:816-256-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy