Provider Demographics
NPI:1407573405
Name:INFUSION CENTER AT PLANTATION POINTE, LLC
Entity Type:Organization
Organization Name:INFUSION CENTER AT PLANTATION POINTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHEALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-285-7414
Mailing Address - Street 1:1025 W MEETING ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2245
Mailing Address - Country:US
Mailing Address - Phone:803-285-7414
Mailing Address - Fax:803-283-4329
Practice Address - Street 1:1025 W MEETING ST STE 102
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2245
Practice Address - Country:US
Practice Address - Phone:803-285-7414
Practice Address - Fax:803-283-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy