Healthcare Provider Details

I. General information

NPI: 1649564535
Provider Name (Legal Business Name): SONAS INFUSION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 MAIN AVE SUITE 4
DURANGO CO
81301-4033
US

IV. Provider business mailing address

PO BOX 2065
HOUSTON TX
77252-2065
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-2500
  • Fax:
Mailing address:
  • Phone: 281-820-1900
  • Fax: 281-820-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number186468
License Number StateCO

VIII. Authorized Official

Name: MS. RENAE BLANTON
Title or Position: OWNER / MANAGER
Credential:
Phone: 970-247-2500