Provider Demographics
NPI:1619213162
Name:INFINITE CARE DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:INFINITE CARE DEVELOPMENT, LLC
Other - Org Name:INFINITE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:520-275-1345
Mailing Address - Street 1:19401 N 73RD LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5617
Mailing Address - Country:US
Mailing Address - Phone:520-275-1345
Mailing Address - Fax:
Practice Address - Street 1:28248 N TATUM BLVD STE B4
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-6343
Practice Address - Country:US
Practice Address - Phone:520-275-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy