Healthcare Provider Details

I. General information

NPI: 1003499286
Provider Name (Legal Business Name): MOSAIC INFUSION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7898 E ACOMA DR STE 106
SCOTTSDALE AZ
85260-3480
US

IV. Provider business mailing address

6912 S QUENTIN ST STE 50
CENTENNIAL CO
80112-4531
US

V. Phone/Fax

Practice location:
  • Phone: 480-573-5165
  • Fax: 844-803-3570
Mailing address:
  • Phone: 720-282-5413
  • Fax: 877-676-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER YOWLER
Title or Position: PRESIDENT
Credential:
Phone: 502-627-7100