Provider Demographics
NPI:1114218906
Name:O'BRIEN INFUSION SERVICES, INC
Entity Type:Organization
Organization Name:O'BRIEN INFUSION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:913-322-0001
Mailing Address - Street 1:5453 W 61ST PL
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3002
Mailing Address - Country:US
Mailing Address - Phone:913-322-0001
Mailing Address - Fax:913-322-0002
Practice Address - Street 1:5453 W 61ST PL
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-3002
Practice Address - Country:US
Practice Address - Phone:913-322-0001
Practice Address - Fax:913-322-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-100303336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy