Organization
ADVANCED INFUSION, LLC
Active
Other names
Vital Care of Hagerstown
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ALBERT KODMAN (OWNER)
(724) 717-2211
Entity
Organization
Contact information
Practice address
1185 IMPERIAL DR STE 101, HAGERSTOWN, MD 21740-6670
(240) 850-4101
(240) 850-4102
Mailing address
1185 IMPERIAL DR STE 101, HAGERSTOWN, MD 21740-6670
(240) 850-4101
(240) 850-4102
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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