Revived Vitality

LBN: Revived Vitality
Revived Vitality is an health care organization with primary practice located at 1301 48Th Ave N # A-2 , Myrtle Beach SC 29577-5427. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Revived Vitality can be contacted via phone (843) 580-3694, or through Perry, Jennings Michael via phone (843) 855-2299.

Contact Information

Primary practice address
1301 48Th Ave N # A-2 Myrtle Beach SC 29577-5427
Phone: (843) 580-3694
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Perry, Jennings Michael DNP
Phone: (843) 855-2299

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1992588750
LBN Legal business name Revived Vitality
DBA Doing business as
Authorized official Perry, Jennings Michael DNP
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2023
Last updated Aug 16th, 2023 - about 3 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.

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