Provider Demographics
NPI:1174263297
Name:INFEXBLOC HOMECARE QOZB LLC
Entity Type:Organization
Organization Name:INFEXBLOC HOMECARE QOZB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:WARUDKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-233-3922
Mailing Address - Street 1:658 E LAGO LINDO RD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-9314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:658 E LAGO LINDO RD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-9314
Practice Address - Country:US
Practice Address - Phone:661-233-3922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care