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General NPI Number Information
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NPI Number | 1295707933
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Entity Type | Organization
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Legal Business Name | PATIENT CARE INFUSION LLC
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 1626 S EDWARD DR
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City | TEMPE
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State | AZ
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Zip | 85281-6200
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Country | US
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Telephone | 602-252-5000
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Fax | 602-323-5070
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Provider Business Mailing Address
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Address Line | 1626 S EDWARD DR
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City | TEMPE
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State | AZ
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Zip | 85281-6200
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Country | US
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Telephone | 602-252-5000
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Fax | 602-323-5070
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Authorized Official
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Title or Position | A R MANAGER
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Name | MR. ROBERT ALLEN COSTON
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Credential |
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Telephone | 602-445-1745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | Y002667
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 303
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 303
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | C000303
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2667
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 3336N0007X
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Taxonomy Name | Nuclear Pharmacy
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License Number | 7572
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 2667
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License Number State | AZ
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