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OPTUM INFUSION SERVICES 403, LLC

Medical Equipment Supplier Yellow Pages

Rohnert Park, California

Provider NPI: 1003926460

Organization Information:
Organization Name:  OPTUM INFUSION SERVICES 403, LLC


Practice Location:
170 PROFESSIONAL CENTER DRIVE, SUITE C  ROHNERT PARK, CA 94928 US
Tel: 800-708-7188  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0004XSuppliers
Pharmacy
Compounding Pharmacy
CALSC 100907
N3336S0011XSuppliers
Pharmacy
Y3336H0001XSuppliers
Pharmacy
CAPHY 53893

Other Provider Identifiers:

IssuerNumberStateType
1003926460CA05
BOARD OF PHARMACYPHY 53893CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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