Healthcare Provider Details

I. General information

NPI: 1740193291
Provider Name (Legal Business Name): RENEW YOU HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SOUTHLAKE LN STE 130
HOOVER AL
35244-3328
US

IV. Provider business mailing address

15 SOUTHLAKE LN STE 130
HOOVER AL
35244-3328
US

V. Phone/Fax

Practice location:
  • Phone: 205-774-8222
  • Fax: 205-319-4899
Mailing address:
  • Phone: 205-774-8222
  • Fax: 205-319-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHAUNDA ELYSE KELLY
Title or Position: OWNER
Credential:
Phone: 205-514-7390