Citadel Infusion Services LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PHRE009889 Issued in GA

Legal business name

CITADEL INFUSION SERVICES LLC

Practice address

2121 New Market Pkwy SE Ste 126
Marietta, GA 30067-9309

Phone

(770) 541-1910

Fax

(770) 541-1916

NPI assigned

Dec 24, 2012

Organization subpart

No

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

Authorized official

Name

Sridevi Katragaddda

Title

Ceo

Phone

(404) 247-9389

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CITADEL INFUSION SERVICES Doing business as

Locations

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

{
    "created_epoch": "1356307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356307200000",
    "number": "1487990271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 NEW MARKET PKWY SE",
            "address_2": "SUITE 126",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679315",
            "telephone_number": "770-541-1910",
            "fax_number": "770-541-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NEW MARKET PKWY SE STE 126",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679309",
            "telephone_number": "770-541-1910",
            "fax_number": "770-541-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITADEL INFUSION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-24",
        "last_updated": "2012-12-24",
        "status": "A",
        "authorized_official_last_name": "KATRAGADDDA",
        "authorized_official_first_name": "SRIDEVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-247-9389"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "GA",
            "license": "PHRE009889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1163079",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CITADEL INFUSION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Infusion Therapy Pharmacy in Marietta, GA
• Providers in Marietta, GA by specialty
• Home Infusion Therapy Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; 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.