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General NPI Number Information
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NPI Number | 1902451552
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Entity Type | Organization
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Legal Business Name | SISU HEALTHCARE SOLUTIONS, INC.
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 914 S 52ND ST STE 110
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City | TEMPE
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State | AZ
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Zip | 85281-9500
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Country | US
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Telephone | 480-999-4488
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Fax | 480-999-4488
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Provider Business Mailing Address
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Address Line | 914 S 52ND ST STE 110
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City | TEMPE
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State | AZ
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Zip | 85281-9500
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Country | US
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Telephone | 480-999-4488
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Fax | 480-999-4488
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCUS E ULM
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Credential |
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Telephone | 702-577-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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