Basic Information
| Provider Information | |||||||||
| NPI: | 1831588102 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AT HOME INFUSION SERVICES LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | KABAFUSION FL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3500 NW BOCA RATON BLVD | ||||||||
| Address2: | STE 704 | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334315851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613534663 | ||||||||
| FaxNumber: | 5613534666 | ||||||||
| Practice Location | |||||||||
| Address1: | 10101 W SAMPLE RD STE 107 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330653937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773092207 | ||||||||
| FaxNumber: | 8773092209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2015 | ||||||||
| LastUpdateDate: | 02/25/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MASOOD | ||||||||
| AuthorizedOfficialFirstName: | SOHAIL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8004353020 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PHARM.D. | ||||||||
| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 299994352 | FL | N | Agencies | Home Health | 251E00000X | Y | Agencies | Home Health |
No ID Information.