Provider Demographics
NPI:1528527256
Name:AXIVA INFUSION CENTERS - HV LLC
Entity type:Organization
Organization Name:AXIVA INFUSION CENTERS - HV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-442-9482
Mailing Address - Street 1:2042 COUNTY LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4929
Mailing Address - Country:US
Mailing Address - Phone:844-442-9482
Mailing Address - Fax:844-440-0101
Practice Address - Street 1:2042 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1739
Practice Address - Country:US
Practice Address - Phone:267-609-2001
Practice Address - Fax:267-609-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty