Provider Demographics
NPI:1245951615
Name:KELNER SPECIALTY INFUSION SERVICES, LLC
Entity type:Organization
Organization Name:KELNER SPECIALTY INFUSION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP
Authorized Official - Prefix:
Authorized Official - First Name:VANETTA
Authorized Official - Middle Name:COX
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-725-8603
Mailing Address - Street 1:3304 EAGLE TRL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4023
Mailing Address - Country:US
Mailing Address - Phone:919-624-6533
Mailing Address - Fax:
Practice Address - Street 1:3200 NORTHLINE AVE STE 110
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7600
Practice Address - Country:US
Practice Address - Phone:336-604-0256
Practice Address - Fax:336-604-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy