Organization Name:  OPTUM INFUSION SERVICES 206 INC


Practice Location:
1201 MONTLIMAR DR STE 900  MOBILE, AL 36609 US
Tel: 877-476-1866  Fax: --

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


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	251E00000X	Agencies Home Health
N	332BP3500X	Suppliers Durable Medical Equipment & Medical Supplies
Y	3336H0001X	Suppliers Pharmacy	AL	113059

Other Provider Identifiers:

Issuer	Number	State	Type
	102360	AL	05
	103251	AL	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin