Basic Information
| Provider Information | |||||||||
| NPI: | 1730734468 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTRAMED PLUS INFUSION & MEDICAL SERVICES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 SALUDA RIDGE CT STE 200 | ||||||||
| Address2: | |||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291693461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037940200 | ||||||||
| FaxNumber: | 8037940404 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 SALUDA RIDGE CT STE 200 | ||||||||
| Address2: | |||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291693461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037940200 | ||||||||
| FaxNumber: | 8037940404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2019 | ||||||||
| LastUpdateDate: | 08/08/2019 | ||||||||
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| AuthorizedOfficialLastName: | RICHARDS | ||||||||
| AuthorizedOfficialFirstName: | VARNER | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 8037940200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QI0500X | Y | Ambulatory Health Care Facilities | Clinic/Center | Infusion Therapy |
No ID Information.