Organization
ELITE INFUSIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIRSTEN PERKINS RN (OWNER)
(623) 210-5041
Entity
Organization
Contact information
Practice address
10252 W VILLA CHULA, PEORIA, AZ 85383
(623) 210-5041
Mailing address
10252 W VILLA CHULA, PEORIA, AZ 85383-2748
(623) 210-5041
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26219
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831145796
PROVIDER NPI
AZ
01
—
26219
ARIZONA MEDICAL LICENSE
AZ
Enumeration date
02/20/2018
Last updated
06/14/2019
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