National Provider Identifier Database

LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
Laboratory Management


Contact Information

LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
5126 PARK RD STE 2C
CHARLOTTE, NC28209-3748
Phone: 704-247-7281
Fax: 704-800-5655
Website:
Specialty Taxonomy Code
* Laboratory Management 246QL0900X
Nursing Care 251J00000X

* Indicates primary specialty

NPI Profile & details for LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS

NPI Number 1720930183
Legal business name
LBN
LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
Authorized official JENNIFER GUILLAUME - (OPERATOR)
Entity Organization
Organization subpart No
Enumeration date 02/10/2026
Last updated 02/10/2026 - About 4 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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