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Organization
JAMES L LARSEN
Active
Organization
JAMES L LARSEN
Active
Other names
TEAM INFUSION
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LARSEN (CEO)
(435) 770-4400
Entity
Organization
Contact information
Practice address
1255 E 3900 S, STE 105, SALT LAKE CITY, UT 84124-1365
(801) 293-3001
(801) 293-7157
Mailing address
1255 E 3900 S, STE 105, SALT LAKE CITY, UT 84124-1365
(801) 293-3001
(801) 293-7157
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
50814
UT
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611011
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/18/2007
Last updated
09/29/2009
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