Ivmedco, Inc

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

13332 Issued in TX

Legal business name

IVMEDCO, INC

Practice address

3646 Granbury Rd, Ste 102
Fort Worth, TX 76109-3717

Phone

(817) 336-4863

Fax

(817) 921-1957

NPI assigned

Oct 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manohar Miryala

Title

Officer

Phone

(817) 921-1957

Specialties & licenses 1

Addresses

Other names 1

• IVMEDCO Fort Worth Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1023193158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 GRANBURY RD, STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093717",
            "telephone_number": "817-336-4863",
            "fax_number": "817-921-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 GRANBURY RD, STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093717",
            "telephone_number": "817-336-4863",
            "fax_number": "817-921-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVMEDCO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "MIRYALA",
        "authorized_official_first_name": "MANOHAR",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "817-921-1957"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "TX",
            "license": "13332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVMEDCO Fort Worth",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "IVMEDCO Fort Worth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Virginia Ives, RD, LD, CDE, LPC
• Danielle Ivey, MD
• Tracy Marie Ivey
• Ivf Laboratories of Fort Worth LLC
• Amber Ivie, RDLD
• Lydia Ann Ivory, LPCI
• Delany Ivy
• Reid E Ivy, CRNA
• Sharon B Ivy
• Joy Anwuli Iweka

• Home Infusion Therapy Pharmacy in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Home Infusion Therapy Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.