OPTUM INFUSION SERVICES 209, INC. (NPI# 1316918436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316918436 |
| Entity Type | Organization |
| Organization Name | OPTUM INFUSION SERVICES 209, INC. |
| Practice Address |
1000 Business Center Drive Ste 120 Savannah GA 31405 |
| Practice Telephone | 8668816505 |
| Practice Fax Number | 8448499188 |
| Mailing Telephone | 8668816505 |
| Mailing Fax Number | 8448499188 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | DAVID JOHN OBERG (VICE PRESIDENT, COMPLIANCE) |
| Authorized Official Telephone | 9499885893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHHH000025 | GA | Suppliers |
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003127988A | 05 | |
| GA | 003127988C | 05 | |
| DEA | FA3317054 | 01 | |
| GA | BOARD OF PHARMACY | PHHH000025 | 01 |
| Other Name | Type Code |
|---|---|
| AxelaCare | Doing Business As Name - Organization |
| Street Address |
1000 BUSINESS CENTER DRIVE STE 120 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| 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 |
|---|---|---|---|---|
| 1770762304 | Walker Home Medical | Pharmacy | 1100 Eisenhower Dr, Ste 19, Savannah, GA 31406-3923 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487990271 | Citadel Infusion Services LLC | Pharmacy | 2121 New Market Pkwy Se Ste 126, Marietta, GA 30067-9309 | 2012-12-24 |
| 1386876597 | Appalachian Home Infusion LLC | Pharmacy | 14 Sammy Mcghee Blvd Ste 103, Jasper, GA 30143-7722 | 2009-08-20 |
| 1275785743 | Pharmaceutical Specialties Inc | Pharmacy | 958 Mcever Rd, Suite B-8, Gainesville, GA 30504-3972 | 2008-10-16 |
| 1780293035 | The Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-23 |
| 1316463417 | Hemogen Rx LLC | Pharmacy | 84 Helen Hwy, Cleveland, GA 30528 | 2017-08-21 |
| 1851721047 | Advanced Home Care Inc | Pharmacy | 5901 Goshen Springs Rd, Ste G, Norcross, GA 30071 | 2013-11-25 |
| 1558510891 | Hamilton Medical Center Inc | Pharmacy | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2008-09-11 |
| 1932326402 | Health Tech Innovations | Pharmacy | 212 Northside Dr, Valdosta, GA 31602-1858 | 2007-04-19 |
| 1497894497 | 1st America Health Services, Inc. | Pharmacy | 212 Northside Dr, Valdosta, GA 31602-1858 | 2007-02-06 |
| 1801935259 | Walker Home Medical | Pharmacy | 100 Brampton Ave, Ste 1f, Statesboro, GA 30458-0827 | 2007-02-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on OPTUM INFUSION SERVICES 209, INC..
| 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.