Provider Demographics
NPI:1588680862
Name:INFINITY HEALTH CARE
Entity Type:Organization
Organization Name:INFINITY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:225-922-7979
Mailing Address - Street 1:2881 POYDRAS BAYOU RD
Mailing Address - Street 2:
Mailing Address - City:ERWINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70729-3422
Mailing Address - Country:US
Mailing Address - Phone:225-627-9581
Mailing Address - Fax:
Practice Address - Street 1:8894 AIRLINE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4081
Practice Address - Country:US
Practice Address - Phone:225-922-7979
Practice Address - Fax:225-922-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4986-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1269247Medicaid
LA5783040001Medicare NSC