Provider Demographics
NPI:1689179855
Name:PARAGON INFUSION THERAPY, LLC
Entity Type:Organization
Organization Name:PARAGON INFUSION THERAPY, LLC
Other - Org Name:VITAL CARE OF DAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-346-9866
Mailing Address - Street 1:1746 THOMAS PAINE PKWY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2541
Mailing Address - Country:US
Mailing Address - Phone:866-346-9866
Mailing Address - Fax:855-633-4357
Practice Address - Street 1:1746 THOMAS PAINE PKWY
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:866-346-9866
Practice Address - Fax:855-633-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPMY022859000-03332B00000X, 332BP3500X, 3336C0004X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy