Provider Demographics
NPI:1760985311
Name:E.V INFUSIONS, LLC
Entity Type:Organization
Organization Name:E.V INFUSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC
Authorized Official - Phone:912-656-6122
Mailing Address - Street 1:203 MALLARD LOOP RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-8123
Mailing Address - Country:US
Mailing Address - Phone:912-450-1160
Mailing Address - Fax:912-450-3971
Practice Address - Street 1:125 SOUTHERN JUNCTION BLVD STE 201
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2214
Practice Address - Country:US
Practice Address - Phone:912-450-1160
Practice Address - Fax:912-450-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN140169363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty