| Renew Med LLC | |
|
300 Industrial Way, Suite 1 Suite 1 Tiverton RI 02878 | |
| (401) 222-0463 | |
| Not Available |
| Full Name | Renew Med LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 300 Industrial Way, Suite 1, Tiverton, Rhode Island |
| Authorized Official Name and Position | Elizabeth Dasha Magriby (OWNER) |
| Authorized Official Contact | 4014774477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Med LLC 300 Industrial Way, Suite 1 Tiverton RI 02878 | Renew Med LLC 300 Industrial Way, Suite 1 Suite 1 Tiverton RI 02878 Ph: (401) 222-0463 |
| NPI Number | 1487471322 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Medicare PECOS PAC ID | 4284157553 |
|---|---|
| Medicare Enrollment ID | O20250327000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487471322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
| Provider Name | Elizabeth D Magriby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780199703 PECOS PAC ID: 8527314160 Enrollment ID: I20180711003481 |
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