Revive Healthcare Solutions LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

REVIVE HEALTHCARE SOLUTIONS LLC

Practice address

100 Grace Hopper LN Ste 3763
Augusta, GA 30901-0009

Phone

(877) 777-9740

NPI assigned

Oct 24, 2023

Last updated

Oct 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tangelia Townsend

Title

Owner

Phone

(877) 777-9740

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1316719248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRACE HOPPER LN STE 3763",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309010009",
            "telephone_number": "877-777-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRACE HOPPER LN STE 3763",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309010009",
            "telephone_number": "877-777-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "TANGELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-777-9740"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.