REVIVE MEDICAL SUPPLIES NPI 1467073098

NPI Information

  • NPI: 1467073098
  • Provider Name: REVIVE MEDICAL SUPPLIES
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Address: 1617 S BURLINGTON AVE
    LOS ANGELES, CA
    ZIP 90006
  • Phone: (949) 390-9105

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NPI Details

REVIVE MEDICAL SUPPLIES is a durable medical equipment medical supplies in Los Angeles, CA. 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 MEDICAL SUPPLIES NPI is 1467073098. The provider is registered as an organization entity type.

The provider's business location address is:

1617 S BURLINGTON AVE
LOS ANGELES, CA
ZIP 90006-567
Phone: (949) 390-9105

The provider's authorized official is Cory Jacobsen .
The authorized official title is Ceo and has the following contact phone number (949) 390-9105.

The enumeration date for this NPI number is 5/5/2020 and was last updated on 1/4/2023.

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
1332B00000XDurable 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: 11/21/2025

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