Provider Demographics
NPI:1164671343
Name:HORIZON INFUSIONS, LLC
Entity Type:Organization
Organization Name:HORIZON INFUSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-619-9229
Mailing Address - Street 1:4260 GLENDALE MILFORD RD STE 1007
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3763
Mailing Address - Country:US
Mailing Address - Phone:513-769-2770
Mailing Address - Fax:513-386-7926
Practice Address - Street 1:4260 GLENDALE MILFORD RD STE 1007
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-3763
Practice Address - Country:US
Practice Address - Phone:513-769-2770
Practice Address - Fax:513-733-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35-04-8567-GOtherSTATE LICENSE NUMBER OHIO MEDICAL BOARD
OH9423991OtherUHC
OH0114191Medicaid
OHA80697OtherUPIN