Advanced Infant Formulas LLC

Organization Active NPI Parenteral & Enteral Nutrition Supplies (DME) · Fountain, CO

NPI 1609059971 · NPPES record last updated Dec 10, 2007

Key facts

NPI
1609059971
Entity type
Organization (NPI type 2)
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Legal business name
ADVANCED INFANT FORMULAS LLC
Practice address
10 Circle C Rd
Fountain, CO 80817-3307
Phone
(719) 201-6231
Fax
(719) 392-4607
NPI assigned
Dec 10, 2007
Organization subpart
No

Authorized official

Name
Mr. Wallace Layne Sisler
Title
Partner
Phone
(719) 201-6231

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Yes

Addresses

Primary practice location

10 Circle C Rd
Fountain, CO 80817-3307

Mailing address

10 Circle C Rd
Fountain, CO 80817-3307
Phone (719) 201-6231

Other providers in Fountain, CO

All providers in Fountain, CO · Parenteral & Enteral Nutrition Supplies (DME) in Colorado

Sources for this page

Verify at the official NPI Registry.