Provider Demographics
NPI:1457872632
Name:TWELFTH ONE, LLC
Entity Type:Organization
Organization Name:TWELFTH ONE, LLC
Other - Org Name:ASPEN INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAIEFSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:602-618-1313
Mailing Address - Street 1:2227 W PECOS RD STE 12
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4866
Mailing Address - Country:US
Mailing Address - Phone:480-739-6040
Mailing Address - Fax:480-739-6072
Practice Address - Street 1:2227 W PECOS RD STE 12
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4866
Practice Address - Country:US
Practice Address - Phone:602-618-1313
Practice Address - Fax:602-801-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 332BP3500X, 333600000X, 3336C0003X, 3336C0004X, 3336S0011X
AZY0072723336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy