Provider Demographics
NPI:1609759026
Name:CASCO BAY INFUSION, LLC
Entity type:Organization
Organization Name:CASCO BAY INFUSION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIK
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:PEREIRA-KAMATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-910-0771
Mailing Address - Street 1:10 DONALD B DEAN DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3372
Mailing Address - Country:US
Mailing Address - Phone:207-910-0771
Mailing Address - Fax:207-910-0772
Practice Address - Street 1:10 DONALD B DEAN DR STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3372
Practice Address - Country:US
Practice Address - Phone:207-910-0771
Practice Address - Fax:207-910-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy