Optum Infusion Services 204, Inc.

LBN: Optum Infusion Services 204, Inc.
Optum Infusion Services 204, Inc. is an health care organization with primary practice located at 4220 Executive Circle, Suite 62 , Fort Myers FL 33916. The organization recently has 3 registered licenses in different health care specialties including Agencies / Home Health, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Optum Infusion Services 204, Inc. can be contacted via phone (239) 561-2388, or through Oberg, David John via phone (949) 988-5893.

Contact Information

Primary practice address
4220 Executive Circle, Suite 62 Fort Myers FL 33916
Fax: (844) 830-1983
Website:
Authorized official contact:
Name: Oberg, David John

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X
Suppliers / Compounding Pharmacy 3336C0004X PH 27821 Florida
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X PH26240 Florida

Profile Details

NPI number 1588936785
LBN Legal business name Optum Infusion Services 204, Inc.
DBA Doing business as
Authorized official Oberg, David John
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2012
Last updated Dec 29th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588936785 NPPES
Florida MEDICAID 015940200
Florida MEDICAID 015940201

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