Provider Demographics
NPI:1265472955
Name:INFUSION CARE, LLC
Entity Type:Organization
Organization Name:INFUSION CARE, LLC
Other - Org Name:ALLIED PREFERRED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:W
Authorized Official - Last Name:SOPER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:513-891-6666
Mailing Address - Street 1:8625 KING GEORGE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2215
Mailing Address - Country:US
Mailing Address - Phone:972-226-0700
Mailing Address - Fax:972-226-0709
Practice Address - Street 1:8625 KING GEORGE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-2215
Practice Address - Country:US
Practice Address - Phone:972-226-0700
Practice Address - Fax:972-226-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336C0004X, 3336S0011X
TX260053336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187661705Medicaid
4539411OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX187661707Medicaid
TX187661706Medicaid
4539411OtherNCPDP PROVIDER IDENTIFICATION NUMBER