Organization
EMPIRE INFUSION PHARMACY INC
Active
Other names
Empire Infusion Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL MONTOYA (OWNER)
(951) 777-1363
Entity
Organization
Contact information
Practice address
2025 CHICAGO AVE, UNIT A3, RIVERSIDE, CA 92507-2315
(951) 777-1363
(951) 444-9577
Mailing address
2025 CHICAGO AVE, UNIT A3, RIVERSIDE, CA 92507-2315
(951) 777-1363
(951) 444-9577
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7996760001
MEDICARE DME PTAN
—
Enumeration date
11/07/2019
Last updated
08/28/2023
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