Provider Demographics
NPI:1093734170
Name:ON-CALL MED INFUSION INC
Entity Type:Organization
Organization Name:ON-CALL MED INFUSION INC
Other - Org Name:ON CALL MED INFUSION , INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-449-6190
Mailing Address - Street 1:337 S CUMBERLAND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3605
Mailing Address - Country:US
Mailing Address - Phone:615-449-6190
Mailing Address - Fax:615-449-6208
Practice Address - Street 1:337 S CUMBERLAND ST
Practice Address - Street 2:SUITE C
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3605
Practice Address - Country:US
Practice Address - Phone:615-449-6190
Practice Address - Fax:615-449-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000031243336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1452161Medicaid
1104020001Medicare ID - Type Unspecified