Healthcare Provider Details

I. General information

NPI: 1659033843
Provider Name (Legal Business Name): ME PIVOT HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 W IMPERIAL HWY STE D
BREA CA
92821-4841
US

IV. Provider business mailing address

150 S 5TH ST STE 2300
MINNEAPOLIS MN
55402-4223
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-7730
  • Fax:
Mailing address:
  • Phone: 763-268-4286
  • Fax: 763-268-4427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: KAYLYNN MURPHY
Title or Position: LEAD BILLING SPECIALIST
Credential:
Phone: 763-268-4286