REVIVE INFUSION CLINIC, LLC; NPI #1457226789

Contact Information

REVIVE INFUSION CLINIC, LLC

19332 WAR ADMIRAL RD
EAGLE RIVER, AK 99577-8482

Phone: 417-793-3935
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Infusion Therapy	261QI0500X
General Practice	208D00000X	99	Physician/Undefined Physician type[6]

Indicates primary specialty

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NPI Profile & details for REVIVE INFUSION CLINIC, LLC

NPI #	`1457226789`
LBN Legal business name	REVIVE INFUSION CLINIC, LLC
Authorized official	MICHAEL SHANNON - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	10/07/2025
Last updated	11/19/2025 - About 7 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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REVIVE INFUSION CLINIC, LLC

Contact Information

Specialty

Infusion Therapy

General Practice

NPI Profile & details for REVIVE INFUSION CLINIC, LLC

Reviews for REVIVE INFUSION CLINIC, LLC