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REVIVE MEDICAL LLC NPI 1669087045


NPI Information

NPI: 1669087045
Provider Name: REVIVE MEDICAL LLC
Classification: Medical Foods Supplier - 335G00000X
Entity Type: Organization
Address:
5000
S SCENIC
BOLIVAR, MO
ZIP 65613
Phone: (417) 777-0797
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REVIVE MEDICAL LLC is a medical foods supplier in Bolivar, MO. The provider is a supplier of special replacement foods for clients with errors of metabolism that prohibit them from eating a regular diet. Medical foods are lacking in the compounds which cause complications of the metabolic disorder, and are not generally available in grocery stores, health food stores, or pharmacies. REVIVE MEDICAL LLC NPI is 1669087045. The provider is registered as an organization entity type.

The provider's business location address is:

5000
S SCENIC
BOLIVAR, MO
ZIP 65613
Phone: (417) 777-0797

The provider's authorized official is Troy Morrison .
The authorized official title is Owner and has the following contact phone number (417) 777-0797.

The enumeration date for this NPI number is 9/11/2020 and was last updated on 9/11/2020.


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
1332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionNo
2335G00000XMedical Foods SupplierYes

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: 5/5/2024

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