Provider Demographics
NPI:1083936678
Name:HEMOPHILIA INFUSION MANAGERS LLC
Entity Type:Organization
Organization Name:HEMOPHILIA INFUSION MANAGERS LLC
Other - Org Name:HEMOPHILIA INFUSION MANAGERS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-459-2256
Mailing Address - Street 1:510 E WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-4861
Mailing Address - Country:US
Mailing Address - Phone:662-286-5894
Mailing Address - Fax:662-286-5896
Practice Address - Street 1:510 E WALDRON ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-4861
Practice Address - Country:US
Practice Address - Phone:662-286-5894
Practice Address - Fax:662-286-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS083733336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2588032OtherNCPDP PROVIDER IDENTIFICATION NUMBER