Indian River Pharmacy

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PH19077 Issued in FL

Legal business name

INDIAN RIVER PHARMACY

Doing business as

Indian River Infusion Services

Practice address

3719 10TH CT
Vero Beach, FL 32960-6559

Phone

(772) 567-2557

Fax

(772) 567-0013

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Gregory Micheael Decrescenzo, R.PH.

Title

President

Phone

(772) 567-2557

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• INDIAN RIVER INFUSION SERVICES Doing business as

Locations

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528274222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 10TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606559",
            "telephone_number": "772-567-2557",
            "fax_number": "772-567-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 10TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606559",
            "telephone_number": "772-567-2557",
            "fax_number": "772-567-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DECRESCENZO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "MICHEAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-567-2557",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "FL",
            "license": "PH19077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1001154",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDIAN RIVER INFUSION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Infusion Therapy Pharmacy in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Home Infusion Therapy Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.