Provider Demographics
NPI:1780910935
Name:CN INFUSION RESOURCES INC
Entity type:Organization
Organization Name:CN INFUSION RESOURCES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-442-9482
Mailing Address - Street 1:1033 STERLING RD STE 102
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-3837
Mailing Address - Country:US
Mailing Address - Phone:703-953-3390
Mailing Address - Fax:703-953-3192
Practice Address - Street 1:1033 STERLING RD STE 102
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3837
Practice Address - Country:US
Practice Address - Phone:703-953-3390
Practice Address - Fax:703-953-3192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNRX10001873336H0001X, 3336H0001X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1780910935Medicaid
2122477OtherPK
MD419747000Medicaid