Provider Demographics
NPI:1558980599
Name:TOTAL INFUSION CARE INC
Entity Type:Organization
Organization Name:TOTAL INFUSION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL AND EXECUTIVE VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSKE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:310-836-6666
Mailing Address - Street 1:3041 W HORIZON RIDGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4444
Mailing Address - Country:US
Mailing Address - Phone:702-778-8880
Mailing Address - Fax:
Practice Address - Street 1:3041 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4444
Practice Address - Country:US
Practice Address - Phone:702-778-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL INFUSION CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-09
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy