Provider Demographics
NPI:1003796889
Name:NUTRISHARE, LLC
Entity type:Organization
Organization Name:NUTRISHARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO / TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PULSIPHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-478-7811
Mailing Address - Street 1:4310 E COTTON CENTER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-8857
Mailing Address - Country:US
Mailing Address - Phone:866-955-5807
Mailing Address - Fax:888-626-3344
Practice Address - Street 1:4310 E COTTON CENTER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-8857
Practice Address - Country:US
Practice Address - Phone:866-955-5807
Practice Address - Fax:888-626-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition