NPIViewer - Provider NPI 1982698189

NPI:	1982698189
Name:	INJECTABLE THERAPY SERVICES INC
Entity Type:	Organization
Organization Name:	INJECTABLE THERAPY SERVICES INC
Other - Org Name:	BIOMATRIX SPECIALTY PHARMACY CA
Other - Org Type:	Doing Business As
Authorized Official - Title/Position:	CEO, PRESIDENT, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:	KATHEE
Authorized Official - Middle Name:	M
Authorized Official - Last Name:	KRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:	954-385-7322
Mailing Address - Street 1:	16625 ARMINTA ST
Mailing Address - Street 2:
Mailing Address - City:	VAN NUYS
Mailing Address - State:	CA
Mailing Address - Zip Code:	91406-1611
Mailing Address - Country:	US
Mailing Address - Phone:	800-404-1963
Mailing Address - Fax:	800-404-4595
Practice Address - Street 1:	16625 ARMINTA ST
Practice Address - Street 2:
Practice Address - City:	VAN NUYS
Practice Address - State:	CA
Practice Address - Zip Code:	91406-1611
Practice Address - Country:	US
Practice Address - Phone:	800-404-1963
Practice Address - Fax:	800-404-4595
EIN:	<UNAVAIL>
Is Organization Subpart?:	Yes
Parent Organization LBN:	BIOLOGICTX LLC
Parent Organization TIN:	<UNAVAIL>
Enumeration Date:	2005-09-02
Last Update Date:	2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:

Primary?	Code	Type	Classification	Specialization
Yes	3336H0001X	Suppliers	Pharmacy	Home Infusion Therapy Pharmacy
No	3336C0003X	Suppliers	Pharmacy	Community/Retail Pharmacy
No	3336S0011X	Suppliers	Pharmacy	Specialty Pharmacy

State	Identifier ID	ID Type	Issuer
CA	PHA449830	Medicaid
MT	1982698189	Medicaid
UT	1982698189	Medicaid
IL	1982698189	Medicaid
NV	1982698189	Medicaid
CA	1982698189	Medicaid
AZ	194063	Medicaid
	2145023	Other	PK
ID	1982698189	Medicaid
PA	1021086790001	Medicaid
WA	6029193	Medicaid