Provider Demographics
NPI:1699535781
Name:CACTUS INFUSION PHARMACY, LLC
Entity type:Organization
Organization Name:CACTUS INFUSION PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALERIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-825-3879
Mailing Address - Street 1:6060 N FOUNTAIN PLAZA DR STE 120
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7871
Mailing Address - Country:US
Mailing Address - Phone:520-230-8886
Mailing Address - Fax:520-844-6560
Practice Address - Street 1:6060 N FOUNTAIN PLAZA DR STE 120
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7871
Practice Address - Country:US
Practice Address - Phone:520-230-8886
Practice Address - Fax:520-844-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy