Revive Health Medical Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REVIVE HEALTH MEDICAL SUPPLIES

Practice address

504 N Carrier Pkwy
Grand Prairie, TX 75050-5428

Phone

(972) 263-7042

Fax

(972) 263-7046

NPI assigned

Feb 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Martin Jones, DPT

Title

Owner/PT

Phone

(972) 263-7042

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1992002695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92282",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920103",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505428",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTH MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "972-263-7042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.