Provider Demographics
NPI:1740826379
Name:REDLINE INFUSION CENTERS, LLC
Entity type:Organization
Organization Name:REDLINE INFUSION CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:REDLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-462-2929
Mailing Address - Street 1:2415 OSBORNE DR E STE 100
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-1999
Mailing Address - Country:US
Mailing Address - Phone:402-462-2929
Mailing Address - Fax:
Practice Address - Street 1:702 N ALPHA ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4318
Practice Address - Country:US
Practice Address - Phone:402-462-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy