Healthcare Provider Details

I. General information

NPI: 1992097828
Provider Name (Legal Business Name): ARIZONA MEDICAL INFUSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20650 N 29TH PL STE 105
PHOENIX AZ
85050-4782
US

IV. Provider business mailing address

20650 N 29TH PL STE 105
PHOENIX AZ
85050-4782
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-3400
  • Fax: 602-445-9265
Mailing address:
  • Phone: 602-788-3400
  • Fax: 602-445-9265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA5086
License Number StateAZ

VIII. Authorized Official

Name: ANTHONY SAMMARTINO
Title or Position: OWNER
Credential: RPH
Phone: 602-788-3400