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Organization

INFUSAL DIRECT, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YIPSIS OROZCO-RUIZ (PRESIDENT)
(313) 361-1030
Entity
Organization

Contact information

Practice address
8315 GRAND RIVER AVE, DETROIT, MI 48204-2231
(313) 361-1030
Mailing address
8315 GRAND RIVER AVE, DETROIT, MI 48204-2231
(313) 361-1030

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OP53590
MEDICARE PTAN
MI
Enumeration date
10/12/2007
Last updated
05/08/2009
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