Healthcare Provider Details

I. General information

NPI: 1699535781
Provider Name (Legal Business Name): CACTUS INFUSION PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 N FOUNTAIN PLAZA DR STE 120
TUCSON AZ
85704-7871
US

IV. Provider business mailing address

6060 N FOUNTAIN PLAZA DR STE 120
TUCSON AZ
85704-7871
US

V. Phone/Fax

Practice location:
  • Phone: 520-230-8886
  • Fax: 520-844-6560
Mailing address:
  • Phone: 520-230-8886
  • Fax: 520-844-6560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROBERT GALERIA
Title or Position: OWNER
Credential:
Phone: 801-825-3879