MEDICARE: RESPECT THE DRIP IV HYDRATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251F00000X	Home Infusion Agency
2	261Q00000X	Clinic/Center
3	251E00000X	Home Health Agency
4	261QM1300X	Multi-Specialty Clinic/Center
5	261QI0500X	Infusion Therapy Clinic/Center

General Provider Information

NPI Number	:	1831047711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESPECT THE DRIP IV HYDRATION LLC

Provider Business Mailing Address
First Line	:	619 HERRELL RD
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-4544
Country	:	US
Telephone Number	:	770-615-6376
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 HERRELL RD
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-4544
Country	:	US
Telephone Number	:	770-615-6376
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOGAN TEAL
Credential	:	NRP
Telephone Number	:	770-527-3729

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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