REJUVAAH & REVVIVED NPI 1114623675

NPI Information

NPI: 1114623675
Provider Name: REJUVAAH & REVVIVED
Classification: Clinic/Center - 261QI0500X
Entity Type: Organization

Specialization: Infusion Therapy

CLIA Number: 01D2277584

Address:
820 S UNIVERSITY BLVD STE 2K
MOBILE, AL
ZIP 36609
Phone: (251) 277-7373
Get Directions

REJUVAAH & REVVIVED is an infusion therapy clinic center in Mobile, AL. REJUVAAH & REVVIVED NPI is 1114623675. The provider is registered as an organization entity type.

The provider's business location address is:

820 S UNIVERSITY BLVD STE 2K
MOBILE, AL
ZIP 36609-860
Phone: (251) 277-7373
Fax: (251) 277-7376

The provider's authorized official is Lawanda Sharee Fantroy .
The authorized official title is Co-founder and has the following contact phone number (228) 235-6015.

The CLIA number assigned to this NPI record is 01D2277584 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2023 and was last updated on 2/6/2023.

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
1	261QI0500X	Clinic/Center	Infusion Therapy			Yes

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

NPI Synchronization or Removal

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