Healthcare Provider Details

I. General information

NPI: 1437904166
Provider Name (Legal Business Name): ON THE MOVE MOBILE IV AND MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14040 N CAVE CREEK RD STE 205
PHOENIX AZ
85022-6179
US

IV. Provider business mailing address

6635 W HAPPY VALLEY RD STE A104-621
GLENDALE AZ
85310-2609
US

V. Phone/Fax

Practice location:
  • Phone: 602-642-7100
  • Fax: 602-581-7162
Mailing address:
  • Phone: 602-642-7100
  • Fax: 602-581-7162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: TERI A HOURIHAN
Title or Position: OWNER/CEO
Credential: PHD LPC
Phone: 602-642-7100