Provider Demographics
NPI:1740923689
Name:SAND MOUNTAIN INFUSION LLC
Entity type:Organization
Organization Name:SAND MOUNTAIN INFUSION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:BRINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-878-2111
Mailing Address - Street 1:209 SAN MOUNTAIN DRIVE EAST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2327
Mailing Address - Country:US
Mailing Address - Phone:256-878-2111
Mailing Address - Fax:256-878-8999
Practice Address - Street 1:209 SAN MOUNTAIN DRIVE EAST
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2327
Practice Address - Country:US
Practice Address - Phone:256-878-2111
Practice Address - Fax:256-878-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy