Medical Infusion Therapy of la

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

License

4428 IR Issued in LA

Legal business name

MEDICAL INFUSION THERAPY OF LA

Practice address

1525 Doctors Dr
Bossier City, LA 71111-3321

Phone

(318) 741-1009

Fax

(318) 741-1842

NPI assigned

Mar 20, 2006

Last updated

Aug 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jean Hoogendyk, RN

Title

Owner - Administrator

Phone

(318) 741-1009

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1194784173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 DOCTORS DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113321",
            "telephone_number": "318-741-1009",
            "fax_number": "318-741-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 DOCTORS DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113321",
            "telephone_number": "318-741-1009",
            "fax_number": "318-741-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL INFUSION THERAPY OF LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "HOOGENDYK",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER - ADMINISTRATOR",
        "authorized_official_telephone_number": "318-741-1009",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "LA",
            "license": "4428 IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1264733",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doran Arthur McQueary, DPT
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• Kenneth John Mekelburg, M.D.

• Infusion Therapy Clinic/Center in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Infusion Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.