Organization
PARK INFUSIONCARE, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM KEYS (CEO)
(480) 446-9010
Entity
Organization
Contact information
Practice address
4319 MEDICAL DRIVE, SUITE 250, SAN ANTONIO, TX 78229
(210) 615-7475
(210) 614-0804
Mailing address
PO BOX 40700, MESA, AZ 85274-0700
(480) 446-9010
(480) 446-7695
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
20559
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
20559
TX
3336H0001X
Home Infusion Therapy Pharmacy
Primary
20559
TX
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130719102
—
TX
05
—
130719106
—
TX
05
—
130719107
—
TX
05
—
320223
—
TX
Enumeration date
10/05/2006
Last updated
08/06/2018
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