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General NPI Number Information
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NPI Number | 1548840192
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Entity Type | Organization
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Legal Business Name | DURANGO INFUSION CENTER, LLC
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 270 E 8TH AVE STE N-101
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City | DURANGO
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State | CO
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Zip | 81301-5708
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Country | US
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Telephone | 970-946-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 270 E 8TH AVE STE N-101
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City | DURANGO
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State | CO
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Zip | 81301-5708
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Country | US
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Telephone | 970-946-3007
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOSS J FENBERG
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Credential | MD
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Telephone | 970-946-3007
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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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