Healthcare Provider Details

I. General information

NPI: 1477270858
Provider Name (Legal Business Name): ATTIGO INFUSION PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 COLLEGE BLVD STE 450
OVERLAND PARK KS
66211-2440
US

IV. Provider business mailing address

15301 SPECTRUM DR STE 330
ADDISON TX
75001-6462
US

V. Phone/Fax

Practice location:
  • Phone: 972-661-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN CRAVEN
Title or Position: DIRECTOR OF RCM
Credential:
Phone: 833-696-3349