Provider Demographics
NPI:1558361758
Name:VISITING NURSE ADVANCED INFUSION SYSTEMS - ANAHEIM
Entity Type:Organization
Organization Name:VISITING NURSE ADVANCED INFUSION SYSTEMS - ANAHEIM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-533-7400
Mailing Address - Street 1:3822 E LA PALMA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1713
Mailing Address - Country:US
Mailing Address - Phone:714-533-7400
Mailing Address - Fax:714-535-3098
Practice Address - Street 1:3822 E LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1713
Practice Address - Country:US
Practice Address - Phone:714-533-7400
Practice Address - Fax:714-535-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY46733332BP3500X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA458170Medicaid
1201580001Medicare ID - Type Unspecified
CAPHY41620Medicare PIN