National Provider Identifier Database

VIVIDLY PROFOUND LLC
Phlebotomy


Contact Information

VIVIDLY PROFOUND LLC
8210 MACEDONIA COMMONS BLVD
STE 3B #2172
MACEDONIA, OH44056
Phone: 440-561-0986
Fax:
Website:
Specialty Taxonomy Code
* Phlebotomy 246RP1900X

* Indicates primary specialty

NPI Profile & details for VIVIDLY PROFOUND LLC

NPI Number 1184565665
Legal business name
LBN
VIVIDLY PROFOUND LLC
Authorized official DESTINY HARRISTON - (MEDICAL ASSISTANT/PHLEBOTOMIST)
Entity Organization
Organization subpart No
Enumeration date 04/01/2026
Last updated 04/01/2026 - About 2 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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