Provider Demographics
NPI:1548735558
Name:A & A INFUSION & SPECIALTY, LLC
Entity Type:Organization
Organization Name:A & A INFUSION & SPECIALTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-580-0020
Mailing Address - Street 1:2044 HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-7806
Mailing Address - Country:US
Mailing Address - Phone:662-332-0177
Mailing Address - Fax:662-537-4953
Practice Address - Street 1:125 E 3RD ST
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:MS
Practice Address - Zip Code:38756-2705
Practice Address - Country:US
Practice Address - Phone:662-332-0177
Practice Address - Fax:662-537-4953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A & A INFUSION & SPECIALTY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy