Provider Demographics
NPI:1548964141
Name:KB INFUSION SERVICES, LLC
Entity type:Organization
Organization Name:KB INFUSION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARDITH
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-419-6688
Mailing Address - Street 1:10119 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-7491
Mailing Address - Country:US
Mailing Address - Phone:304-419-6688
Mailing Address - Fax:
Practice Address - Street 1:10119 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-7491
Practice Address - Country:US
Practice Address - Phone:304-419-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion