Provider Demographics
NPI:1619411592
Name:INFINIUM HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:INFINIUM HEALTH SERVICES LLC
Other - Org Name:INFINIUM HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILREATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-944-5575
Mailing Address - Street 1:10130 MALLARD CREEK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6000
Mailing Address - Country:US
Mailing Address - Phone:704-944-5575
Mailing Address - Fax:704-944-5578
Practice Address - Street 1:10130 MALLARD CREEK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-6000
Practice Address - Country:US
Practice Address - Phone:704-944-5575
Practice Address - Fax:704-944-5578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4868251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care