VIVIDLY PROFOUND LLC – NPI #1184565665
Technician, Pathology

VIVIDLY PROFOUND LLC is a pathology technician located in MACEDONIA, OH. NPPES recently assigned the NPI number 1184565665 to VIVIDLY PROFOUND LLC on April 01, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 246RP1900X from the Health Care Provider Taxonomy code set, which is classified as Technician, Pathology, specializing in Phlebotomy

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 VIVIDLY PROFOUND LLC below.

NPI Profile for
VIVIDLY PROFOUND LLC

NPI Number
1184565665
Enumeration Date

(about 2 months 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
VIVIDLY PROFOUND LLC
Primary location
8210 MACEDONIA COMMONS BLVD
STE 3B #2172
MACEDONIA, OH 44056
Phone: (440) 561-0986 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DESTINY HARRISTON
MEDICAL ASSISTANT/PHLEBOTOMIST
Phone: (440) 561-0986
Updated
Certification Date
Apr 01, 2026

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
246RP1900X
- Technician, Pathology / Phlebotomy (Primary)

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.