Organization
EMPIRE INFUSION PHARMACY INC
Active
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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