Healthcare Provider Details

I. General information

NPI: 1558771378
Provider Name (Legal Business Name): H2B2AZ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29850 N TATUM BLVD SUITE 114
CAVE CREEK AZ
85331-5867
US

IV. Provider business mailing address

29850 N TATUM BLVD SUITE 114
CAVE CREEK AZ
85331-5867
US

V. Phone/Fax

Practice location:
  • Phone: 480-562-2302
  • Fax: 480-946-0901
Mailing address:
  • Phone: 480-562-2302
  • Fax: 480-946-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BILL NIEDERER
Title or Position: MANAGING MEMBER
Credential:
Phone: 480-563-2302