Organization
EXECUTIVE INFUSION SERVICES LLC
Active
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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