Revival Medical Supplies, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REVIVAL MEDICAL SUPPLIES, INC.

Practice address

9550 Warner Ave Ste 250-09
Fountain Valley, CA 92708-2800

Phone

(949) 229-5703

NPI assigned

Feb 15, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emad Ali

Title

Ceo

Phone

(347) 391-2751

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1154076404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 WARNER AVE STE 250-09",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082800",
            "telephone_number": "949-229-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 WARNER AVE STE 250-09",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082800",
            "telephone_number": "949-229-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "EMAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-391-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.