Organization Name: | REVOLUTION CARE, INC. |
NPI Number: | 1255582300 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN JOSEPH WHITMAN (PRESIDENT) |
Mailing Address: | 105 Thatcher Ct North Wales |
State: | PA US |
Postal Code: | 194541226 |
Phone Number: | 4845576980 |
Fax Number: | 2159976771 |
NPI Enumeration Date: | 10/07/2008 |
NPI Last Update Date: | 12/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |