VIVIDLY PROFOUND LLC NPI 1184565665

NPI Information

  • NPI: 1184565665
  • Provider Name: VIVIDLY PROFOUND LLC
  • Classification: Technician, Pathology - 246RP1900X
  • Specialization: Phlebotomy
  • Entity Type: Organization
  • Address: 8210 MACEDONIA COMMONS BLVD
    STE 3B #2172
    MACEDONIA, OH
    ZIP 44056
  • Phone: (440) 561-0986

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NPI Details

VIVIDLY PROFOUND LLC is a phlebotomy technician pathology in Macedonia, OH. VIVIDLY PROFOUND LLC NPI is 1184565665. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8210 MACEDONIA COMMONS BLVD
STE 3B #2172
MACEDONIA, OH
ZIP 44056
Phone: (440) 561-0986

The provider's authorized official is Destiny Harriston .
The authorized official title is Medical Assistant/phlebotomist and has the following contact phone number (440) 561-0986.

The enumeration date for this NPI number is 4/1/2026 and was last updated on 4/1/2026.

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
1246RP1900XTechnician, PathologyPhlebotomyYes

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: 11/21/2025

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