REVIVE WOUND CARE GA LLC – NPI #1548082274
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

REVIVE WOUND CARE GA LLC is a provider located in CLARKSTON, GA. NPPES has assigned the NPI number 1548082274 to REVIVE WOUND CARE GA LLC on October 24, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for REVIVE WOUND CARE GA LLC below.

NPI Profile for
REVIVE WOUND CARE GA LLC

NPI Number
1548082274
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
REVIVE WOUND CARE GA LLC
Primary location
980 ROWLAND ST
STE 5140 #1111
CLARKSTON, GA 30021
Phone: (951) 760-6216 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PAUL DAVIS
MANAGER
Phone: (951) 760-6216
Updated
Certification Date
Oct 17, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
251E00000X
- Home Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.