Provider Demographics
NPI:1912614215
Name:VERTEX IN-OFFICE INFUSION LLC
Entity Type:Organization
Organization Name:VERTEX IN-OFFICE INFUSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-932-3506
Mailing Address - Street 1:500 S UNIVERSITY AVE STE 815
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5310
Mailing Address - Country:US
Mailing Address - Phone:501-747-1064
Mailing Address - Fax:501-747-1087
Practice Address - Street 1:500 S UNIVERSITY AVE STE 815
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5310
Practice Address - Country:US
Practice Address - Phone:501-747-1064
Practice Address - Fax:501-747-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty