OPTUM INFUSION SERVICES 202, INC.
9655 Florida Mining Boulevard W. #411
Jacksonville, FL 32257
866-680-5744
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336C0004X | Suppliers - Pharmacy - Compounding Pharmacy | ||
N | 3336M0003X | Suppliers - Pharmacy | ||
N | 3336S0011X | Suppliers - Pharmacy | ||
Y | 3336H0001X | Suppliers - Pharmacy | FL | PH22242 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1023441 | OTHER | |
016047800 | FL | MEDICAID | |
016047801 | FL | MEDICAID |