Provider Demographics
NPI:1447518717
Name:SOS INFUSION, LLC
Entity type:Organization
Organization Name:SOS INFUSION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-799-9064
Mailing Address - Street 1:12615 W AIRPORT BLVD
Mailing Address - Street 2:SUITE #700
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6202
Mailing Address - Country:US
Mailing Address - Phone:281-799-9064
Mailing Address - Fax:
Practice Address - Street 1:12615 W AIRPORT BLVD
Practice Address - Street 2:SUITE #700
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6202
Practice Address - Country:US
Practice Address - Phone:281-799-9064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty