OPTUM INFUSION SERVICES 204, INC. (NPI# 1588936785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588936785 |
| Entity Type | Organization |
| Organization Name | OPTUM INFUSION SERVICES 204, INC. |
| Practice Address |
4220 Executive Circle, Suite 62 Fort Myers FL 33916 |
| Practice Telephone | 2395612388 |
| Practice Fax Number | 8448301983 |
| Mailing Telephone | 2395612388 |
| Mailing Fax Number | 8448301983 |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | DAVID OBERG (CEO) |
| Authorized Official Telephone | 9499885893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH 27821 | FL | Suppliers |
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PH26240 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015940200 | 05 | |
| FL | 015940201 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356538771 | Optum Infusion Services 204, Inc. | Pharmacy | 201 N. Tarragona Street, Pensacola, FL 32502 | 2007-09-30 |
| 1982795209 | Optum Infusion Services 204, Inc. | Home Health | 8509 Benjamin Rd Ste A, Tampa, FL 33634-1224 | 2006-09-28 |
| Street Address |
4220 EXECUTIVE CIRCLE, SUITE 62 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982251377 | Tamara Alvarez | Behavioral Analyst | 3717 Metro Pkey, Apt 3207, Fort Myers, FL 33916 | 2019-08-21 |
| 1457853798 | Grant Community Residential Home | Community Health Worker | 2252 Wright Street (a), Fort Myers, FL 33916 | 2018-03-02 |
| 1811345887 | Alexis Walker | Specialist/Technologist | 1407 Gardenia Avenue, Fort Myers, FL 33916 | 2016-05-31 |
| 1346698669 | Irving Radiology, Inc | Radiology | 4110 Center Pointe Dr Ste 210, Fort Myers, FL 33916 | 2016-05-26 |
| 1629452347 | Ashley Ann Alberts | Nurse Practitioner | 4315 Metro Parkway, Suite 150, Fort Myers, FL 33916 | 2015-07-13 |
| 1932442837 | Nicolas Alonzo Bolanos | Counselor | 4150 Ford Street Extension, Fort Myers, FL 33916 | 2013-03-29 |
| 1700181047 | Michele Lintz | Case Manager/Care Coordinator | 1280 Maravilla Lane, Ft Myers, FL 33916 | 2011-01-18 |
| 1821399114 | Dollar Rx Pharmacy | Pharmacy | 2950 Winkler Ave # 701, Fort Myers, FL 33916 | 2010-11-03 |
| 1942494687 | Benjamin M. Lowe | Pharmacist | 3033 Winkler Ave Ext, Fort Myers, FL 33916 | 2007-09-05 |
| 1881806545 | Ali Saharkhiz-langroodi | Psychiatry & Neurology | 3303 Winkler Extension, Fort Myers, FL 33916 | 2007-05-04 |
| Find all providers in zip 33916 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| 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. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770090482 | Eventus Rx Inc | Pharmacy | 11300 Lindbergh Blvd Ste 107, Fort Myers, FL 33913-8827 | 2018-01-03 |
| 1285866459 | In Home Health, LLC. | Pharmacy | 13650 Metropolis Ave Ste 105, Fort Myers, FL 33912-4375 | 2009-08-20 |
| 1932418969 | Aarric Inc | Pharmacy | 16970 San Carlos Blvd, Suite 110, Fort Myers, FL 33908-1236 | 2010-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437590791 | New Era Pharmaceuticals LLC | Pharmacy | 3350 Nw 53rd St, 102, Ft Lauderdale, FL 33309-6354 | 2013-07-15 |
| 1831481027 | Smp Pharmacy Solutions, LLC | Pharmacy | 7500 Nw 26th St Ste 101, Miami, FL 33122-1414 | 2011-05-06 |
| 1154623023 | Hospice of Palm Beach County, Inc. | Pharmacy | 300 Northpoint Pkwy Ste 301, West Palm Beach, FL 33407-1979 | 2010-11-29 |
| 1588897375 | Reliance Pharmacy LLC | Pharmacy | 2100 45th St Ste B1, West Palm Beach, FL 33407-2063 | 2009-08-27 |
| 1174784334 | Florida Hhi LLC | Pharmacy | 6704 Benjamin Rd, Ste 700, Tampa, FL 33634-4408 | 2008-06-20 |
| 1972784841 | Complete Pharmacy and Medical Solutions LLC | Pharmacy | 5829 Nw 158th St, Miami Lakes, FL 33014-6721 | 2007-11-20 |
| 1881881522 | Infusal Partners | Pharmacy | 9655 Florida Mining Blvd W, Bldg 400, Suites 410-411, Jacksonville, FL 32257-2031 | 2007-09-26 |
| 1053514976 | Infusal Partners | Pharmacy | 5505 Johns Rd, Suite 700, Tampa, FL 33634-4307 | 2007-06-07 |
| 1528274222 | Indian River Pharmacy | Pharmacy | 3719 10th Ct, Vero Beach, FL 32960-6559 | 2007-05-16 |
| 1891838496 | Heartland Pharmacy Inc | Pharmacy | 6360 Us 27 N, Sebring, FL 33870-1225 | 2007-02-14 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33916 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.