KETAMINE INFUSION CENTERS INC NPI 1740790823

NPI Information

NPI: 1740790823
Provider Name: KETAMINE INFUSION CENTERS, INC

Doing Business As: KETAMINE INFUSION CENTERS

Classification: Clinic/Center - 261QI0500X
Entity Type: Organization

Specialization: Infusion Therapy

Address:
3724 N 3RD ST STE 201
PHOENIX, AZ
ZIP 85012
Phone: (480) 331-4222
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KETAMINE INFUSION CENTERS, INC is an infusion therapy clinic center in Phoenix, AZ. KETAMINE INFUSION CENTERS, INC NPI is 1740790823. The provider is registered as an organization entity type.
The provider Is Doing Business As Ketamine Infusion Centers.

The provider's business location address is:

3724 N 3RD ST STE 201
PHOENIX, AZ
ZIP 85012-034
Phone: (480) 331-4222
Fax: (480) 404-9649

The provider's authorized official is Sonny Diaz .
The authorized official title is Director and has the following contact phone number (602) 344-9850.

The CLIA number assigned to this NPI record is 03D2141220 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2017 and was last updated on 7/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center				No
2	261QI0500X	Clinic/Center	Infusion Therapy			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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