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General NPI Number Information
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NPI Number | 1487122974
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Entity Type | Organization
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Legal Business Name | CORINTHIAN INFUSION GROUP LLC
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 4032 N MILLER RD STE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4572
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Country | US
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Telephone | 214-632-4399
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Fax |
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Provider Business Mailing Address
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Address Line | 509 COYOTE RD
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City | SOUTHLAKE
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State | TX
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Zip | 76092-1979
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Country | US
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Telephone | 817-742-0095
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Fax | 817-742-0097
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUDI MCQUEARY
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Credential |
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Telephone | 817-742-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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