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Contact Information

REVIVE & REMEDY, LLC
2851 SHELBY ST
BARTLETT, TN38134-4509
 Phone: 901-335-8541
 Fax: 901-425-9685
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Point of Service

305S00000X
 

Health Service

261QH0100X
Indicates primary specialty

NPI Profile & details for REVIVE & REMEDY, LLC

NPI # 1528735602
LBN Legal business name REVIVE & REMEDY, LLC
Authorized official TERRI WALLACE-BASKEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/25/2021
Last updated 02/02/2022 - About 4 years 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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