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NPI Code Detail

MEDICARE: EMPIRE INFUSION PHARMACY INC

MEDICARE: EMPIRE INFUSION PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336H0001XHome Infusion Therapy Pharmacy
23336C0003XCommunity/Retail Pharmacy

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17996760001OTHERMEDICARE DME PTAN

General Provider Information

NPI Number : 1629613260
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPIRE INFUSION PHARMACY INC
Provider Business Mailing Address
First Line : 2025 CHICAGO AVE
Second Line : UNIT A3
City : RIVERSIDE
State : CA
Zip : 92507-2315
Country : US
Telephone Number : 951-777-1363
Fax Number : 951-444-9577
Provider Business Practice Location Address
First Line : 2025 CHICAGO AVE
Second Line : UNIT A3
City : RIVERSIDE
State : CA
Zip : 92507-2315
Country : US
Telephone Number : 951-777-1363
Fax Number : 951-444-9577
Authorized Official
Title or Position : OWNER
Name : MANUEL MONTOYA
Credential :
Telephone Number : 951-777-1363
Provider Enumeration Date : 11/07/2019
Last Update Date : 08/28/2023

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Directions to “EMPIRE INFUSION PHARMACY INC ” Practice Location

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