Provider Demographics
NPI:1083817027
Name:NORTHERN INFUSION LLC
Entity Type:Organization
Organization Name:NORTHERN INFUSION LLC
Other - Org Name:NORTHERN INFUSION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:MONROUZEAU ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-815-1563
Mailing Address - Street 1:162 CALLE JOSE RODRIGUEZ IRIZ
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4468
Mailing Address - Country:US
Mailing Address - Phone:787-815-1563
Mailing Address - Fax:787-881-5146
Practice Address - Street 1:162 CALLE JOSE RODRIGUEZ IRIZ
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4468
Practice Address - Country:US
Practice Address - Phone:787-815-1563
Practice Address - Fax:787-881-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy