LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS; NPI #1720930183

Contact Information

LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS

5126 PARK RD STE 2C
CHARLOTTE, NC 28209-3748

Phone: 704-247-7281
Fax: 704-800-5655
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Laboratory Management	246QL0900X
Nursing Care	251J00000X

Indicates primary specialty

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

NPI Number	`1720930183`
LBN Legal business name	LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
Authorized official	JENNIFER GUILLAUME - (OPERATOR)
Entity	Organization
Organization subpart ¹	No
Enumeration date	02/10/2026
Last updated	02/10/2026 - About 4 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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