| Renew You Health & Wellness Llc | |
|
15 Southlake Ln Ste 130 Hoover AL 35244-3328 | |
| (205) 774-8222 | |
| Not Available |
| Full Name | Renew You Health & Wellness Llc |
|---|---|
| Speciality | Dentist |
| Location | 15 Southlake Ln Ste 130, Hoover, Alabama |
| Authorized Official Name and Position | Shaunda Kelly (CEO) |
| Authorized Official Contact | 2055147390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew You Health & Wellness Llc 1849 Data Dr Ste 1 Hoover AL 35244-1202 Ph: (205) 774-8222 | Renew You Health & Wellness Llc 15 Southlake Ln Ste 130 Hoover AL 35244-3328 Ph: (205) 774-8222 |
| NPI Number | 1407530025 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 08/15/2024 |
| Medicare PECOS PAC ID | 8123551959 |
|---|---|
| Medicare Enrollment ID | O20241031001565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407530025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Shaunda Kelly |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659540508 PECOS PAC ID: 8022377563 Enrollment ID: I20210715002555 |
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