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Revive Family Medical Clinic, Llc
Clinic/Center in Columbus, Mississippi
NPI 1902577554

Revive Family Medical Clinic, Llc is a Clinic/Center based in Columbus, MS. Revive Family Medical Clinic, Llc practices in Columbus, MS. The NPI Number for Revive Family Medical Clinic, Llc is 1902577554 and holds a License No. (Mississippi).

The current practice location address for Revive Family Medical Clinic, Llc is 3549 Bluecutt Rd, Columbus, MS and can be reached out via phone at 662-386-1541. You can also correspond with Revive Family Medical Clinic, Llc through the mailing address at 3549 BLUECUTT RD, COLUMBUS, MS - 39705-1324 (mailing address contact number: 662-570-4174).

Location: 3549 Bluecutt Rd, Columbus, MS, 39705-1324
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1902577554
Provider Name
Revive Family Medical Clinic, Llc
Credential
Provider Entity Type
Organization
Address
3549 Bluecutt Rd, Columbus, MS, 39705-1324
Phone Number
662-386-1541
Fax Number
Provider Enumeration Date
09/23/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06975501 05 MS
R874310 01 MS MISSISSIPPI BOARD OF NURSING- RN
F0115273 01 AANP
1437558061 01 NPI-1
institution
Provider Business Practice Location Address Details
Address
3549 Bluecutt Rd
City
Columbus
State
Mississippi
Zip
39705-1324
Phone Number
662-386-1541
Fax Number
person
Provider Business Mailing Address Details
Address
3549 Bluecutt Rd
City
Columbus
State
Mississippi
Zip
39705-1324
Phone Number
662-386-1541
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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