OPTUM INFUSION SERVICES 204 INC. NPI 1356538771

NPI Information

NPI: 1356538771
Provider Name: OPTUM INFUSION SERVICES 204, INC.
Classification: Pharmacy - 3336H0001X
Entity Type: Organization

Specialization: Home Infusion Therapy Pharmacy

Address:
826 CREIGHTON RD
UNIT A103
PENSACOLA, FL
ZIP 32504
Phone: (866) 522-8438
Get Directions

OPTUM INFUSION SERVICES 204, INC. is a home infusion therapy pharmacy pharmacy in Pensacola, FL. The provider is pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. OPTUM INFUSION SERVICES 204, INC. NPI is 1356538771. The provider is registered as an organization entity type.

The provider's business location address is:

826 CREIGHTON RD
UNIT A103
PENSACOLA, FL
ZIP 32504-076
Phone: (866) 522-8438
Fax: (844) 246-1271

The provider's authorized official is David John Oberg .
The authorized official title is Assistant Secretary and has the following contact phone number (949) 988-5893.

The enumeration date for this NPI number is 9/30/2007 and was last updated on 2/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3336C0004X	Pharmacy	Compounding Pharmacy	PH27820	FLORIDA	No
2	3336M0003X	Pharmacy	Managed Care Organization Pharmacy			No
3	3336S0011X	Pharmacy	Specialty Pharmacy			No
4	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	PH22890	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1029215	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	016048600	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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