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REVIVE MEDICAL CENTER LLC NPI 1740996636


NPI Information

NPI: 1740996636
Provider Name: REVIVE MEDICAL CENTER LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 01D2277640

Address:
1728 11TH AVE
HALEYVILLE, AL
ZIP 35565
Phone: (205) 485-7822
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REVIVE MEDICAL CENTER LLC is a family medicine in Haleyville, AL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. REVIVE MEDICAL CENTER LLC NPI is 1740996636. The provider is registered as an organization entity type.

The provider's business location address is:

1728 11TH AVE
HALEYVILLE, AL
ZIP 35565-506
Phone: (205) 485-7822
Fax: (260) 399-4004

The provider's authorized official is Larry Jake Pickens .
The authorized official title is Owner/president and has the following contact phone number (205) 485-7822.

The CLIA number assigned to this NPI record is 01D2277640 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/25/2023 and was last updated on 2/22/2023.


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
1261QU0200XClinic/CenterUrgent CareNo
2207Q00000XFamily MedicineYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.