Provider Demographics
NPI:1326683244
Name:DRAGONFLY INFUSION SERVICES
Entity Type:Organization
Organization Name:DRAGONFLY INFUSION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKUS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:724-414-1425
Mailing Address - Street 1:264 SMITH TOWNSHIP STATE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-2124
Mailing Address - Country:US
Mailing Address - Phone:724-414-1425
Mailing Address - Fax:855-445-4203
Practice Address - Street 1:100 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3734
Practice Address - Country:US
Practice Address - Phone:614-406-6313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy