Revitalife Wellness Center, Llc is a medicare enrolled "General Practice" provider in Washington Court House, Ohio. Their current practice location is
108 N Hinde St, Washington Court House, Ohio. You can reach out to their office (for appointments etc.) via phone at
(740) 406-1709.
Revitalife Wellness Center, Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Revitalife Wellness 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 1215794169.
Healthcare Provider's Profile
| Full Name | Revitalife Wellness Center, Llc |
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| Type | Facility |
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| Speciality | General Practice |
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| Location | 108 N Hinde St, Washington Court House, Ohio |
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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: 1215794169
- Provider Enumeration Date: 03/05/2024
- Last Update Date: 03/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 8123549045
- Enrollment ID: O20250307003013
Medical Identifiers
Medical identifiers for Revitalife Wellness Center, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215794169 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Revitalife Wellness Center, Llc acts as a billing entity for following providers:
| Provider Name | Joseph Anthony Latona |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1558390864
PECOS PAC ID: 1951371392
Enrollment ID: I20140416002345 |
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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. Revitalife Wellness 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 |
|---|
Revitalife Wellness Center, Llc
1670 Courtney Dr,
Washington Court House, OH 43160-8914
Ph: (740) 606-8308 | Revitalife Wellness Center, Llc
108 N Hinde St,
Washington Court House, OH 43160-1371
Ph: (740) 406-1709 |
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