Healthcare Provider Details

I. General information

NPI: 1447903059
Provider Name (Legal Business Name): INFUSION MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 SOUTH STAPLEY DR STE 130
MESA AZ
85204-6677
US

IV. Provider business mailing address

DEPT LA 25560
PASADENA CA
91185-0001
US

V. Phone/Fax

Practice location:
  • Phone: 805-719-3700
  • Fax: 805-413-9099
Mailing address:
  • Phone: 805-719-3700
  • Fax: 888-377-0160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREGORY BLANKENSHIP
Title or Position: VP, REVENUE CYCLE
Credential:
Phone: 682-227-9690