Provider Demographics
NPI:1912572942
Name:AMERICAN RIVER INFUSION SERVICES
Entity Type:Organization
Organization Name:AMERICAN RIVER INFUSION SERVICES
Other - Org Name:AMERICAN RIVER INFUSION SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:830-752-7394
Mailing Address - Street 1:3855 N FREEWAY BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2934
Mailing Address - Country:US
Mailing Address - Phone:916-239-7900
Mailing Address - Fax:
Practice Address - Street 1:3855 N FREEWAY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2934
Practice Address - Country:US
Practice Address - Phone:916-239-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy