# THRIVE HEALTH IV CLINIC, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THRIVE HEALTH IV CLINIC P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1083314744
- **Legal business name:** THRIVE HEALTH IV CLINIC P.C.
- **Authorized official:** DR. RAYMOND DOUGLAS MD (PRESIDENT)
- **Authorized official phone:** (310) 363-8757

## Contact information

- **Practice address:** 2001 N HALSTED ST STE 200, CHICAGO, IL 60614-4365
- **Practice address phone:** (310) 363-8757
- **Practice address fax:** (310) 363-8758
- **Mailing address:** 9675 BRIGHTON WAY STE 410, BEVERLY HILLS, CA 90210-5192
- **Mailing address phone:** (310) 363-8757
- **Mailing address fax:** (310) 363-8758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/09/2023
- **Last updated:** 05/11/2023