Organization
1ST AMERICA INFUSION SERVICES LLC
Active
Organization
1ST AMERICA INFUSION SERVICES LLC
Active
Other names
Advanced InfusionCare
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON CASTELLANOS (CEO)
(601) 988-1700
Entity
Organization
Contact information
Practice address
212 NORTHSIDE DR, VALDOSTA, GA 31602-1858
(229) 242-3060
(292) 242-9914
Mailing address
212 NORTHSIDE DR, VALDOSTA, GA 31602-1858
(229) 242-3040
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PHRE008040
GA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019860
PK
—
05
—
323764040A
—
GA
Enumeration date
08/04/2006
Last updated
11/04/2022
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