Provider Demographics
NPI:1881441574
Name:RISING PERFORMANCE HEALTH, LLC
Entity type:Organization
Organization Name:RISING PERFORMANCE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERIDETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-280-0079
Mailing Address - Street 1:3901 SINGER BLVD NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5846
Mailing Address - Country:US
Mailing Address - Phone:505-350-8277
Mailing Address - Fax:855-886-0343
Practice Address - Street 1:3901 SINGER BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5846
Practice Address - Country:US
Practice Address - Phone:505-280-0079
Practice Address - Fax:855-886-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty