Organization
STREAMLINE TOTALCARE LLC
Active
Other names
THREE RIVERS INFUSION AND PHCY SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP VON BURG (PRESIDENT)
(740) 622-1175
Entity
Organization
Contact information
Practice address
238 MAIN ST, COSHOCTON, OH 43812-1507
(740) 622-1175
(740) 622-0715
Mailing address
PO BOX 1287, COSHOCTON, OH 43812-6287
(740) 622-1175
(740) 622-0715
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
020517450
OH
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0782676
—
OH
01
—
3662081
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/28/2005
Last updated
11/02/2009
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