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Contact Information

LIMITLESS EVOLUTION LLC
3524 OSAGE BEACH PKWY
OSAGE BEACH, MO65065-5622
 Phone: 573-693-9818
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Clinic/Center

261Q00000X
 

Contractor

171W00000X
 

Military/U.S. Coast Guard Outpatient

261QM1100X
Indicates primary specialty

NPI Profile & details for LIMITLESS EVOLUTION LLC

NPI # 1215534805
LBN Legal business name LIMITLESS EVOLUTION LLC
Authorized official JUSTIN DESKIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/06/2020
Last updated 10/06/2020 - About 6 years ago
Identifiers
Other 9HAHHA800 HIN
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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