| Organization Name: | INFUSOURCE, LLC |
| NPI Number: | 1003926460 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROXANNE SMITH (CORPORATE COUNSEL) |
| Mailing Address: | 170 Professional Center Dr Suite C Rohnert Park |
| State: | CA US |
| Postal Code: | 949282144 |
| Phone Number: | 7075888894 |
| Fax Number: | 7075888908 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 05/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336H0001X |
| License Number: | PHY51653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Home Infusion Therapy Pharmacy |
| Taxonomy Definition: | Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |