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General NPI Number Information
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NPI Number | 1396733176
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Entity Type | Organization
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Legal Business Name | WESTERN MEDICAL INFUSION, INC.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2202 E UNIVERSITY DR STE B
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City | PHOENIX
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State | AZ
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Zip | 85034-6804
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Country | US
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Telephone | 602-257-9347
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Fax | 602-275-9194
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Provider Business Mailing Address
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Address Line | 2202 E UNIVERSITY DR STE B
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City | PHOENIX
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State | AZ
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Zip | 85034-6804
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Country | US
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Telephone | 602-257-9347
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Fax | 602-275-9194
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS CROWELL
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Credential |
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Telephone | 602-302-8475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 3935
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License Number State | AZ
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