Provider Demographics
NPI:1225224447
Name:NORTH STAR INFUSION, INC
Entity Type:Organization
Organization Name:NORTH STAR INFUSION, INC
Other - Org Name:DBA: NORTH STAR PHARMACY AND INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:R.PH.
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:307-637-4300
Mailing Address - Street 1:7124 COMMONS DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-2620
Mailing Address - Country:US
Mailing Address - Phone:307-637-4300
Mailing Address - Fax:307-637-4306
Practice Address - Street 1:7124 COMMONS DR UNIT B
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-2620
Practice Address - Country:US
Practice Address - Phone:307-637-4300
Practice Address - Fax:307-637-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYR10031332BP3500X, 3336C0003X, 3336C0004X, 3336H0001X, 3336L0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYFN0512841OtherDEA
WYFN0512841OtherDEA