Provider Demographics
NPI:1578207668
Name:INFINITY PHARMACY GROUP LLC
Entity Type:Organization
Organization Name:INFINITY PHARMACY GROUP LLC
Other - Org Name:INFINITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CASAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-372-2700
Mailing Address - Street 1:305 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3125
Mailing Address - Country:US
Mailing Address - Phone:931-372-2700
Mailing Address - Fax:931-372-2701
Practice Address - Street 1:305 W SPRING ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3125
Practice Address - Country:US
Practice Address - Phone:931-372-2700
Practice Address - Fax:931-372-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy