Provider Demographics
NPI:1174199947
Name:REVIVE HEALTH. INC
Entity Type:Organization
Organization Name:REVIVE HEALTH. INC
Other - Org Name:APPLE RX PHARMACY STORE #3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THINH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:949-232-3948
Mailing Address - Street 1:626 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1616
Mailing Address - Country:US
Mailing Address - Phone:562-600-3125
Mailing Address - Fax:562-600-3126
Practice Address - Street 1:626 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1616
Practice Address - Country:US
Practice Address - Phone:562-600-3125
Practice Address - Fax:562-600-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy