Provider Demographics
NPI:1558691543
Name:GUADALUPE REGIONAL INFUISON CENTER
Entity Type:Organization
Organization Name:GUADALUPE REGIONAL INFUISON CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-444-3570
Mailing Address - Street 1:1064 E IRELAND ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-4849
Mailing Address - Country:US
Mailing Address - Phone:830-401-4455
Mailing Address - Fax:
Practice Address - Street 1:1064 E IRELAND ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-4849
Practice Address - Country:US
Practice Address - Phone:830-401-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy