Provider Demographics
NPI:1114058534
Name:PARAGON HEMOPHILIA SOLUTIONS LLC
Entity Type:Organization
Organization Name:PARAGON HEMOPHILIA SOLUTIONS LLC
Other - Org Name:PARAGON HEALTHCARE SPECIALTY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FINAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-588-1000
Mailing Address - Street 1:3033 W PRESIDENT GEORGE BUSH HWY STE 100-B
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-5752
Mailing Address - Country:US
Mailing Address - Phone:972-588-1000
Mailing Address - Fax:866-388-1488
Practice Address - Street 1:3033 W PRESIDENT GEORGE BUSH HWY STE 100B
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5752
Practice Address - Country:US
Practice Address - Phone:888-588-1072
Practice Address - Fax:866-388-1488
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAGON HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254533336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPH0618OtherMEDICARE LOCAL CARRIER - TRAILBLAZER HEALTH SERVICES
OK200662540Medicaid
TX149518Medicaid