| Revive Infusion Clinic, Llc | |
|
19332 War Admiral Rd Eagle River AK 99577-8482 | |
| (417) 793-3935 | |
| Not Available |
| Full Name | Revive Infusion Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Infusion Therapy |
| Location | 19332 War Admiral Rd, Eagle River, Alaska |
| Authorized Official Name and Position | Michael Joseph Shannon (OWNER) |
| Authorized Official Contact | 4177933935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Infusion Clinic, Llc 19332 War Admiral Rd Eagle River AK 99577-8482 Ph: (417) 793-3935 | Revive Infusion Clinic, Llc 19332 War Admiral Rd Eagle River AK 99577-8482 Ph: (417) 793-3935 |
| NPI Number | 1457226789 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 10/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457226789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QI0500X | Clinic/center - Infusion Therapy | (* (Not Available)) | Primary |
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