VIVIDLY PROFOUND LLC; NPI #1184565665

Contact Information

VIVIDLY PROFOUND LLC

8210 MACEDONIA COMMONS BLVD
STE 3B #2172
MACEDONIA, OH 44056

Phone: 440-561-0986
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Phlebotomy	246RP1900X

Indicates primary specialty

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NPI Profile & details for VIVIDLY PROFOUND LLC

NPI #	`1184565665`
LBN Legal business name	VIVIDLY PROFOUND LLC
Authorized official	DESTINY HARRISTON - (MEDICAL ASSISTANT/PHLEBOTOMIST)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/01/2026
Last updated	04/01/2026 - About 2 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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VIVIDLY PROFOUND LLC

Contact Information

Specialty

Phlebotomy

NPI Profile & details for VIVIDLY PROFOUND LLC

Reviews for VIVIDLY PROFOUND LLC