Provider Demographics
NPI:1508411182
Name:EVENTUS INFUSION LLC
Entity type:Organization
Organization Name:EVENTUS INFUSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP MANAGED CARE CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILOLAHTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-282-2382
Mailing Address - Street 1:6912 S QUENTIN ST STE 50
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4531
Mailing Address - Country:US
Mailing Address - Phone:720-282-5325
Mailing Address - Fax:877-676-0493
Practice Address - Street 1:11300 LINDBERGH BLVD STE 107A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8827
Practice Address - Country:US
Practice Address - Phone:239-204-5984
Practice Address - Fax:866-330-7487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113959608Medicaid
FL113959606Medicaid
FL113959611Medicaid
FL113959607Medicaid
FL113959612Medicaid
FL113959600Medicaid
FL113959605Medicaid