Organization · Type 2 NPI
Revive Medical LLC
Medical Foods Supplier · Bolivar, MO
NPI number
1669087045
Active
Practice location
5000, S Scenic
Bolivar, MO 65613
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | None listed |
| Medical Foods Supplier Primary | 335G00000X | None listed |
Medical Foods Supplier: A supplier of special replacement foods for clients with errors of metabolism that prohibit them from eating a regular diet. Medical foods are lacking in the compounds which cause complications of the metabolic disorder, and are not generally available in grocery stores, health food stores, or pharmacies.
About NPI 1669087045
Revive Medical LLC's National Provider Identifier is 1669087045, issued on Sep 11, 2020. The primary taxonomy on file is Medical Foods Supplier (335G00000X), and the practice location is in Bolivar, MO. The record was last updated on Sep 11, 2020.