Organization
EXECUTIVE INFUSION SERVICES LLC
Active
Other names
Executive Infusion Services
Organization subpart
No
Provider details
NPI number
Authorized official
AIMAN ABUEIDA (OWNER)
(313) 523-5334
Entity
Organization
Contact information
Practice address
17000 EXECUTIVE PLAZA DR, SUITE 201, DEARBORN, MI 48126-2793
(313) 982-3220
(313) 982-3221
Mailing address
17000 EXECUTIVE PLAZA DR, SUITE 201, DEARBORN, MI 48126-2793
(313) 982-3220
(313) 982-3221
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
5301010096
MI
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135839
PK
—
Enumeration date
06/05/2012
Last updated
05/09/2024
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