Colorado State Infusion, Inc.

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PDO.0530000052 Issued in CO

Legal business name

COLORADO STATE INFUSION, INC.

Practice address

1401 N 1St St
Grand Junction, CO 81501-2115

Phone

(970) 243-3411

Fax

(970) 243-3364

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Joe Brayton

Title

Chief Strategy Officer/Evp

Phone

(972) 588-1050

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• COLORADO STATE INFUSION INC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacy Anderson

  • Pharmacist
  • Grand Junction, CO
  • NPI 1710114038
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1689714495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17111 PRESTON RD",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481229",
            "telephone_number": "866-972-5888",
            "fax_number": "866-491-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 1ST ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012115",
            "telephone_number": "970-243-3411",
            "fax_number": "970-243-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO STATE INFUSION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "BRAYTON",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CHIEF STRATEGY OFFICER/EVP",
        "authorized_official_telephone_number": "972-588-1050"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "CO",
            "license": "PDO.0530000052",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2003295",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF REGULATORY AGENCIES",
            "identifier": "PDO.0530000052",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84152877",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLORADO STATE INFUSION INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COLORADO STATE INFUSION INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Grand Junction, CO
• Home Infusion Therapy Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.