ELITE INFUSION IV HYDRATION LLC (NPI# 1063047587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063047587 |
| Entity Type | Organization |
| Organization Name | ELITE INFUSION IV HYDRATION LLC |
| Practice Address |
6136 Walnut St Philadelphia PA 19139-3704 |
| Practice Telephone | 2675168048 |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | SHAVON PARKER (CEO) |
| Authorized Official Telephone | 2675168048 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | ||
| Y | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
Ambulatory Health Care Facilities |
| Street Address |
6136 WALNUT ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19139-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891202644 | Codered Healthcare Services LLC | Home Health | 6136 Walnut St, Philadelphia, PA 19139-3704 | 2018-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1770192890 | Michael Pappano LLC | Social Worker | 31 South 51st St, Philadelphia, PA 19139 | 2020-07-24 |
| 1912419581 | Christina Lipuma | Dietitian, Registered | 5210 Haverford Ave, Philadelphia, PA 19139 | 2017-11-03 |
| 1538515564 | New Vitae Inc | Public Health or Welfare | 27 S 55th Street, Philadelphia, PA 19139 | 2016-05-09 |
| 1982058681 | Phyllis Mwaura | In Home Supportive Care | 5338 Vine Street, Basement, Philadelphia, PA 19139 | 2016-04-19 |
| 1861879322 | Barbara Joette Hegarty | Counselor | 4508 Chestnut Street, Philadelphia, PA 19139 | 2015-05-04 |
| 1336533454 | Julie Magallanes-montone | Family Medicine | 5201 Haverford Avenue, Philadelphia, PA 19139 | 2015-03-26 |
| 1134494909 | The Children's Hospital of Philadelphia | Pediatrics | 4865 Market Street, Philadelphia, PA 19139 | 2012-03-13 |
| 1467757443 | Nouman Bashir | Dentist | 5139 Chestnut Stree, Philadelphia, PA 19139 | 2011-01-21 |
| 1720396732 | Serena Denise Johnson | Contractor | 5151a Walnut Street, Philadelphia, PA 19139 | 2010-09-24 |
| Find all providers in zip 19139 | ||||
| Taxonomy Code | 261QI0500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Infusion Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679832448 | Oasis Infusion Center PC | Clinic/Center | 1926 Grant Avenue, Philadelphia, PA 19115-4307 | 2012-05-14 |
| 1164627816 | Integrated Center for Neuropathy | Clinic/Center | 8355 Loretto Ave, Philadelphia, PA 19152-1830 | 2007-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285283044 | Jk Marketing, LLC | Clinic/Center | 6091 Steubenville Pike Ste 7b, Mc Kees Rocks, PA 15136-1336 | 2019-09-05 |
| 1972065043 | Axiva Infusion Centers - Ht LLC | Clinic/Center | 1120 W Township Line Rd Ste 300, Havertown, PA 19083-4929 | 2019-04-05 |
| 1255892535 | Jk Marketing, LLC | Clinic/Center | 280 Indian Springs Rd Ste 131, Indiana, PA 15701-3676 | 2019-03-28 |
| 1528527256 | Axiva Infusion Centers - Hv LLC | Clinic/Center | 2042 County Line Rd, Huntingdon Valley, PA 19006-1739 | 2019-03-12 |
| 1083187520 | East Goshen Pharmacy, Inc. | Clinic/Center | 729 Grove Ave Unit 5, Southampton, PA 18966-6008 | 2019-01-08 |
| 1811419088 | Infusion Center of Berks County PC | Clinic/Center | 2760 Century Blvd Ste 3, Wyomissing, PA 19610-3359 | 2017-07-10 |
| 1184179236 | Infusion Express of Pennsylvania Pllc | Clinic/Center | 70 E Swedesford Rd Ste 130, Malvern, PA 19355-1482 | 2016-08-18 |
| 1700181476 | Option Care Enterprises, Inc | Clinic/Center | 540 Seco Rd, Suite A, Monroeville, PA 15146-1460 | 2011-01-11 |
| 1033166244 | Chartwell Pennsylvania, Lp | Clinic/Center | 1001 Oakdale Rd, Oakdale, PA 15071-1502 | 2006-05-31 |
| 1124073507 | Option Care Enterprises, Inc. | Clinic/Center | 4000 Chemical Rd, Suite 100, Plymouth Meeting, PA 19462-1728 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19139 |
Please comment or provide details below to improve the information on ELITE INFUSION IV HYDRATION LLC.
| 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.