Organization
INFUSION SERVICES & SPECIALTY PHARMACY
Active
Other names
ISRX CORP
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA PROCTOR (CCO)
(817) 453-5022
Entity
Organization
Contact information
Practice address
1724 E BROAD ST STE 136, MANSFIELD, TX 76063-9140
(817) 453-5022
(817) 453-5027
Mailing address
1724 E BROAD ST STE 136, MANSFIELD, TX 76063-9140
(817) 453-5022
(817) 453-5027
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321070
—
TX
Enumeration date
04/02/2021
Last updated
04/02/2021
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