Provider Demographics
NPI:1629830526
Name:PROMPTCARE HOME INFUSION, LLC
Entity Type:Organization
Organization Name:PROMPTCARE HOME INFUSION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-692-2704
Mailing Address - Street 1:41 SPRING ST STE 103B
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1143
Mailing Address - Country:US
Mailing Address - Phone:866-776-6782
Mailing Address - Fax:
Practice Address - Street 1:1922 HIGHWAY 22 W STE A
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-9490
Practice Address - Country:US
Practice Address - Phone:985-792-9001
Practice Address - Fax:985-792-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy