Organization
PURE INFUSION SUITES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT JACOBSEN (PARTNER)
(435) 760-2547
Entity
Organization
Contact information
Practice address
222 S MAIN ST STE 500, SALT LAKE CITY, UT 84101-2275
(801) 855-9978
Mailing address
1465 E 1425 N, LOGAN, UT 84341-2898
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
12/09/2019
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