Provider Demographics
NPI:1457153306
Name:INJX BAR LLC
Entity type:Organization
Organization Name:INJX BAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER / WELLNESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-737-5076
Mailing Address - Street 1:10200 W HAPPY VALLEY PKWY STE 125
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2878
Mailing Address - Country:US
Mailing Address - Phone:480-737-5076
Mailing Address - Fax:
Practice Address - Street 1:10200 W HAPPY VALLEY PKWY STE 125
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2878
Practice Address - Country:US
Practice Address - Phone:480-737-5076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty