Revitalize Medical Supply
NPI #1508533209 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1508533209
- Entity Type
- Organization
- Organization Name
- Revitalize Medical Supply
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Aug 30, 2021
- Last Updated
- Jan 17, 2025
Practice Location
- Address
- 1680 ELK CREEK DR # 2
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-1225
- Phone
- (208) 757-4325
Authorized Official
- Name
- WHITNEY WHITWORTH
- Title
- OWNER
- Phone
- (208) 589-0821
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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