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Organization

IMPACT INFUSION CARE, LLC.

Active
Other names
Impact Infusion Care
Organization subpart
No

Provider details

NPI number
Authorized official
DUSTIN WILLIAM KOENNING R.PH, PHARM.D. (PHARMACIST IN CHARGE)
(806) 577-3370
Entity
Organization

Contact information

Practice address
9000 TESORO DR STE 600, SAN ANTONIO, TX 78217-6130
(210) 646-4888
(726) 800-4974
Mailing address
9000 TESORO DR STE 600, SAN ANTONIO, TX 78217-6130
(210) 646-4888
(726) 800-4974

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
251G00000X
Community Based Hospice Care Agency
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
3336C0004X
Compounding Pharmacy
3336H0001X
Home Infusion Therapy Pharmacy
Primary
3336S0011X
Specialty Pharmacy

Other

Enumeration date
06/23/2023
Last updated
11/30/2023
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