Revive Medical Center, Llc is a medicare enrolled "Internal Medicine" provider in Lawrenceville, Georgia. Their current practice location is
753 Old Norcross Rd Ste A, Lawrenceville, Georgia. You can reach out to their office (for appointments etc.) via phone at
(770) 545-8888.
Revive Medical Center, Llc is licensed to practice in Georgia (license number ) and it also participates in the medicare program. Revive Medical Center, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1750801205.
Healthcare Provider's Profile
| Full Name | Revive Medical Center, Llc |
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| Type | Facility |
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| Speciality | Internal Medicine |
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| Location | 753 Old Norcross Rd Ste A, Lawrenceville, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750801205
- Provider Enumeration Date: 06/26/2017
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 4789924606
- Enrollment ID: O20190312003167
Medical Identifiers
Medical identifiers for Revive Medical Center, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750801205 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (Georgia) | Secondary |
| 207R00000X | Internal Medicine | (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Revive Medical Center, Llc acts as a billing entity for following providers:
| Provider Name | Michael Schulman |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1174755300
PECOS PAC ID: 8224250915
Enrollment ID: I20150226001469 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Revive Medical Center, Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Revive Medical Center, Llc
753 Old Norcross Rd Ste A,
Lawrenceville, GA 30046-4312
Ph: (770) 545-8888 | Revive Medical Center, Llc
753 Old Norcross Rd Ste A,
Lawrenceville, GA 30046-4312
Ph: (770) 545-8888 |
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