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OPTUM INFUSION SERVICES 550, LLC
Specialty Pharmacy >> Pharmacy >> SuppliersRegistrant NPI Number: 1578866752
Organizational Registrant:Organization Name: OPTUM INFUSION SERVICES 550, LLC
Organization is not Subpart
Authorized Official: DAVID JOHN OBERG ASSISTANT SECRETARY 949--98-85893
Organization is not Subpart
Authorized Official: DAVID JOHN OBERG ASSISTANT SECRETARY 949--98-85893
Location and contact information for practice:
20 COMMERCE WAY STE 2 WOBURN, MA 01801-1057 US
Tel: 781-287-1500 Fax: 781-287-1502
Tel: 781-287-1500 Fax: 781-287-1502
Contact information for business:
266 W CUMMINGS PARK WOBURN, MA 01801-6346 US
Tel: 781-287-1500 Fax: 781-287-1502
Tel: 781-287-1500 Fax: 781-287-1502
Registration Information:
NPI: 1578866752
Entity Type: Organization
Entity Type: Organization
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 3336S0011X | Suppliers Pharmacy Specialty Pharmacy | ||
| N | 332B00000X | Suppliers Durable Medical Equipment & Medical Supplies | ||
| N | 332BP3500X | Suppliers Durable Medical Equipment & Medical Supplies | ||
| N | 333600000X | Suppliers Pharmacy | ||
| N | 3336H0001X | Suppliers Pharmacy | MA | DS89763 |
| Y | 3336C0004X | Suppliers Pharmacy |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 442196500 | MD | 05 | |
| 0297739 | NJ | 05 | |
| 0297097 | NJ | 05 | |
| 3088738 | NH | 05 | |
| 441160900 | MD | 05 | |
| 10090166A | MA | 05 | |
| 102080003002 | PA | 05 | |
| PK | 2127970 | 01 | |
| 1020535 | VT | 05 |
