Healthcare Provider Details
I. General information
NPI: 1255067591
Provider Name (Legal Business Name): MOSAIC INFUSION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2022
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 AIRPORT HEIGHTS DR STE 355
ANCHORAGE AK
99508-2990
US
IV. Provider business mailing address
6912 S QUENTIN ST STE 50
CENTENNIAL CO
80112-4531
US
V. Phone/Fax
- Phone: 907-206-4139
- Fax: 844-472-0441
- Phone: 720-282-5325
- Fax: 833-871-9247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
YOWLER
Title or Position: PRESIDENT
Credential:
Phone: 502-627-7100