Provider Demographics
NPI:1336286384
Name:NBN INFUSIONS INC
Entity Type:Organization
Organization Name:NBN INFUSIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:BOETTCHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-669-0217
Mailing Address - Street 1:2 PIN OAK LN
Mailing Address - Street 2:UNIT 250
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1632
Mailing Address - Country:US
Mailing Address - Phone:856-669-0217
Mailing Address - Fax:856-424-8913
Practice Address - Street 1:2 PIN OAK LN
Practice Address - Street 2:UNIT 250
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1630
Practice Address - Country:US
Practice Address - Phone:856-669-0217
Practice Address - Fax:856-424-8913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X
NJ28R5004542003336C0003X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0004052000OtherPERSONAL CHOICE
NJ19968OtherUNIVERSITY HEALTH PLANS
PA34546OtherHEALTH PARTNERS
NJ43512OtherAMERIGROUP
PA0004052000OtherKEYSTONE HEALTH PLAN
NJ116388OtherAETNA
NJ4533402Medicaid
AZ3193327OtherNCPDP
NJA1000663OtherOXFORD
NJ3193327OtherNAPB NUMBER
NJ0004052000OtherAMERIHEALTH
NJ1036043OtherHORIZON NJ HEALTH
NJBU0000115-01OtherAMERICHOICE NJ
NJ2K0662OtherHEALTHNET
NJ=========IOtherHORIZON BLUE CROSS OF NJ
NJ=========IOtherHORIZON BLUE CROSS OF NJ