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REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE INC NPI 1841900636


NPI Information

NPI: 1841900636
Provider Name: REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
3955 HARRISON RD STE 200B
LOGANVILLE, GA
ZIP 30052
Phone: (770) 209-9913
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REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC is a durable medical equipment medical supplies in Loganville, GA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC NPI is 1841900636. The provider is registered as an organization entity type.

The provider's business location address is:

3955 HARRISON RD STE 200B
LOGANVILLE, GA
ZIP 30052-502
Phone: (770) 209-9913
Fax: (678) 902-8579

The provider's authorized official is Shevin D Pollydore .
The authorized official title is Physician/owner and has the following contact phone number (770) 209-9913.

The enumeration date for this NPI number is 12/1/2022 and was last updated on 12/1/2022.


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
1333600000XPharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesYes

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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