Provider Demographics
NPI:1497111272
Name:HOWLAND INFUSION CENTER LLC
Entity Type:Organization
Organization Name:HOWLAND INFUSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSSACECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-469-6120
Mailing Address - Street 1:8600 E MARKET ST
Mailing Address - Street 2:SUITE #10
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2375
Mailing Address - Country:US
Mailing Address - Phone:330-469-6120
Mailing Address - Fax:330-469-5247
Practice Address - Street 1:8600 E MARKET ST
Practice Address - Street 2:SUITE #10
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2375
Practice Address - Country:US
Practice Address - Phone:330-469-6120
Practice Address - Fax:330-469-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
OHPMY.022590050-03336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168003OtherPK