Provider Demographics
NPI:1417679622
Name:ADVANCED INFUSION SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED INFUSION SERVICES, LLC
Other - Org Name:ADVANCED INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-696-8010
Mailing Address - Street 1:4020 21ST ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1126
Mailing Address - Country:US
Mailing Address - Phone:806-696-8010
Mailing Address - Fax:806-696-8020
Practice Address - Street 1:4020 21ST ST STE 3
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1126
Practice Address - Country:US
Practice Address - Phone:806-696-8010
Practice Address - Fax:806-696-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center