Organization
AZURE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLY WIJAYA (PARTNER/OWNER)
(479) 880-1117
Entity
Organization
Contact information
Practice address
220 EAST 4TH STREET, RUSSELLVILLE, AR 72801
(479) 880-1117
Mailing address
220 EAST 4TH STREET, RUSSELLVILLE, AR 72801
(479) 880-1117
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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