Provider Demographics
NPI:1912024381
Name:IV SPECIALISTS INC
Entity Type:Organization
Organization Name:IV SPECIALISTS INC
Other - Org Name:IV SPECIALISTS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-912-8525
Mailing Address - Street 1:25B MARSHELLEN DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6900
Mailing Address - Country:US
Mailing Address - Phone:843-524-3777
Mailing Address - Fax:843-524-3776
Practice Address - Street 1:24 COMMERCE PL
Practice Address - Street 2:STE D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3699
Practice Address - Country:US
Practice Address - Phone:866-881-6505
Practice Address - Fax:843-524-3776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBIENT HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X
GAPHHH0000313336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1155402OtherNCPDP PROVIDER IDENTIFICATION NUMBER