Revive Spa Hydration Pllc
LBN: Revive Spa Hydration Pllc
Revive Spa Hydration Pllc is an health care organization with primary practice located at 17609 29Th Avenue Ct E , Tacoma WA 98445-4622. The organization recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Infusion Therapy, Nursing Service Providers / Nutrition Support, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Infusion Therapy. Ambulatory Health Care Facilities / Infusion Therapy is the primary health care specialty.
Revive Spa Hydration Pllc can be contacted via phone (253) 257-8340, or through Schubert, Beth Ann via phone (253) 257-8340.
Contact Information
Primary practice address
17609 29Th Avenue Ct E
Tacoma WA 98445-4622
Phone: (253) 257-8340
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Infusion Therapy | 163WI0500X | ||
| Nursing Service Providers / Nutrition Support | 163WN1003X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Infusion Therapy | 261QI0500X |
Profile Details
| NPI number | 1326712100 |
|---|---|
| LBN Legal business name | Revive Spa Hydration Pllc |
| DBA Doing business as | |
| Authorized official | Schubert, Beth Ann Registered Nurse (RN) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Aug 4th, 2021 |
| Last updated | Aug 6th, 2021 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326712100 | NPPES |
| Washington | MEDICAID | 1609417203 |
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