Organization
ENLIVEN HOME INFUSION SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERICK MIRAMONTES MBA (PRESIDENT)
(623) 698-4725
Entity
Organization
Contact information
Practice address
11875 W MCDOWELL RD APT 1168, AVONDALE, AZ 85392-3105
(623) 698-4725
Mailing address
11875 W MCDOWELL RD APT 1168, AVONDALE, AZ 85392-3105
(623) 698-4725
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
L18512080
AZ
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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