Provider Demographics
NPI:1013250018
Name:THE CLINICAL INFUSION CENTER
Entity type:Organization
Organization Name:THE CLINICAL INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:TOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-821-9339
Mailing Address - Street 1:2121 S MILL AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3303 S LINDSAY RD
Practice Address - Street 2:SUITE 123
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1503
Practice Address - Country:US
Practice Address - Phone:480-821-9939
Practice Address - Fax:480-821-9555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANNAH MEDICAL INSTITUTE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29620174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty