Healthcare Provider Details

I. General information

NPI: 1649840190
Provider Name (Legal Business Name): ME PIVOT HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11339 183RD ST
CERRITOS CA
90703-5434
US

IV. Provider business mailing address

11339 183RD ST
CERRITOS CA
90703-5434
US

V. Phone/Fax

Practice location:
  • Phone: 562-257-3985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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