Provider Demographics
NPI:1770634834
Name:INFUSION PHARMACY SERVICES, INC
Entity Type:Organization
Organization Name:INFUSION PHARMACY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:608-375-4466
Mailing Address - Street 1:1028 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-1532
Mailing Address - Country:US
Mailing Address - Phone:608-375-4466
Mailing Address - Fax:608-375-2383
Practice Address - Street 1:1028 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1532
Practice Address - Country:US
Practice Address - Phone:608-375-4466
Practice Address - Fax:608-375-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7127-042333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5121900OtherNABP