Provider Demographics
NPI:1255683306
Name:INFINITI PHARMACY AND INFUSION SERVICES INC
Entity type:Organization
Organization Name:INFINITI PHARMACY AND INFUSION SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:P
Authorized Official - Last Name:RANADE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:954-414-9900
Mailing Address - Street 1:1338 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-3730
Mailing Address - Country:US
Mailing Address - Phone:954-414-9900
Mailing Address - Fax:954-943-4573
Practice Address - Street 1:1338 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3730
Practice Address - Country:US
Practice Address - Phone:954-414-9900
Practice Address - Fax:954-943-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH26771OtherPHARMACY LICENSE
FL009613000Medicaid
FL5712179OtherNCPDP
FL5712179OtherNCPDP