Provider Demographics
NPI:1952742231
Name:NEWLIFE INFUSION CENTER
Entity Type:Organization
Organization Name:NEWLIFE INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADY
Authorized Official - Suffix:
Authorized Official - Credentials:FINANCIAL EXPERT
Authorized Official - Phone:855-200-6672
Mailing Address - Street 1:29020 AGOURA RD
Mailing Address - Street 2:A8
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2573
Mailing Address - Country:US
Mailing Address - Phone:855-200-6672
Mailing Address - Fax:
Practice Address - Street 1:29020 AGOURA RD
Practice Address - Street 2:A8
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2573
Practice Address - Country:US
Practice Address - Phone:855-200-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy