Provider Demographics
NPI:1194368605
Name:ADVANCED INFUSION SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED INFUSION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-242-2272
Mailing Address - Street 1:1901 MEDI PARK DR STE 1057
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2168
Mailing Address - Country:US
Mailing Address - Phone:806-242-2272
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 1057
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2168
Practice Address - Country:US
Practice Address - Phone:806-242-2272
Practice Address - Fax:806-242-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy