Provider Demographics
NPI:1740936103
Name:RENEWED HEALTH INFUSION CENTER LLC
Entity type:Organization
Organization Name:RENEWED HEALTH INFUSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:520-298-0005
Mailing Address - Street 1:2825 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5309
Mailing Address - Country:US
Mailing Address - Phone:520-298-0005
Mailing Address - Fax:520-326-2626
Practice Address - Street 1:2825 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5309
Practice Address - Country:US
Practice Address - Phone:520-298-0005
Practice Address - Fax:520-326-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty