Provider Demographics
NPI:1912911330
Name:W&F HIGH TECH SYSTEMS, LLC
Entity Type:Organization
Organization Name:W&F HIGH TECH SYSTEMS, LLC
Other - Org Name:ACTIVE INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:N/A
Authorized Official - Prefix:
Authorized Official - First Name:N/A
Authorized Official - Middle Name:
Authorized Official - Last Name:N/A
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:555-555-5555
Mailing Address - Street 1:25219 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-4211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4505 MONROE ST
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4740
Practice Address - Country:US
Practice Address - Phone:555-555-5555
Practice Address - Fax:555-555-5555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-28
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160816Medicaid
MI4790336Medicaid
OH2160816Medicaid
OH1306860001Medicare ID - Type Unspecified