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NPI Code Detail

MEDICARE: INFINIA AT CAMP VERDE

MEDICARE: INFINIA AT CAMP VERDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityNCI-366AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134125750
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFINIA AT CAMP VERDE
Provider Business Mailing Address
First Line : 15 E HIGHWAY 260
Second Line :
City : CAMP VERDE
State : AZ
Zip : 86322-6864
Country : US
Telephone Number : 928-567-5253
Fax Number : 928-567-3794
Provider Business Practice Location Address
First Line : 15 E HIGHWAY 260
Second Line :
City : CAMP VERDE
State : AZ
Zip : 86322-6864
Country : US
Telephone Number : 928-567-5253
Fax Number : 928-567-3794
Authorized Official
Title or Position : OWNER
Name : SCOTT ROBERTSON
Credential :
Telephone Number : 801-295-8000
Provider Enumeration Date : 06/28/2005
Last Update Date : 08/22/2020

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Directions to “INFINIA AT CAMP VERDE ” Practice Location

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