REVIVE WOUND CARE GA LLC NPI 1548082274

NPI Information

  • NPI: 1548082274
  • Provider Name: REVIVE WOUND CARE GA LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 980 ROWLAND ST
    STE 5140 #1111
    CLARKSTON, GA
    ZIP 30021
  • Phone: (951) 760-6216

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NPI Details

REVIVE WOUND CARE GA LLC is a general practice in Clarkston, GA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee REVIVE WOUND CARE GA LLC NPI is 1548082274. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

980 ROWLAND ST
STE 5140 #1111
CLARKSTON, GA
ZIP 30021
Phone: (951) 760-6216

The provider's authorized official is Paul Davis .
The authorized official title is Manager and has the following contact phone number (951) 760-6216.

The enumeration date for this NPI number is 10/24/2024 and was last updated on 10/24/2024.

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
1208D00000XGeneral PracticeYes
2251E00000XHome HealthNo

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: 3/30/2025

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