Provider Demographics
NPI:1508869694
Name:I V SOLUTIONS INC
Entity Type:Organization
Organization Name:I V SOLUTIONS INC
Other - Org Name:IV SOLUTIONS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:POTELUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-457-9201
Mailing Address - Street 1:162 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1726
Mailing Address - Country:US
Mailing Address - Phone:570-457-9201
Mailing Address - Fax:570-457-0465
Practice Address - Street 1:162 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-1726
Practice Address - Country:US
Practice Address - Phone:570-457-9201
Practice Address - Fax:570-457-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414691L3336H0001X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013071650001Medicaid
2081422OtherPK
0570370001Medicare NSC