Provider Demographics
NPI:1720317092
Name:INFINITY CARE INC.
Entity Type:Organization
Organization Name:INFINITY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:J
Authorized Official - Last Name:VAN PAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-845-5085
Mailing Address - Street 1:324 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:LUXEMBURG
Mailing Address - State:WI
Mailing Address - Zip Code:54217-1369
Mailing Address - Country:US
Mailing Address - Phone:920-845-5085
Mailing Address - Fax:920-845-5086
Practice Address - Street 1:324 ROBIN LN
Practice Address - Street 2:
Practice Address - City:LUXEMBURG
Practice Address - State:WI
Practice Address - Zip Code:54217-1369
Practice Address - Country:US
Practice Address - Phone:920-845-5085
Practice Address - Fax:920-845-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0012647172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty