| Organization Name: | ADVANCED INFANT FORMULAS LLC |
| NPI Number: | 1609059971 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WALLACE LAYNE SISLER (PARTNER) |
| Mailing Address: | 10 Circle C Rd Fountain |
| State: | CO US |
| Postal Code: | 808173307 |
| Phone Number: | 7192016231 |
| Fax Number: | 7193924607 |
| NPI Enumeration Date: | 12/10/2007 |
| NPI Last Update Date: | 12/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |