Healthcare Provider Details

I. General information

NPI: 1871263392
Provider Name (Legal Business Name): ME PIVOT HOLDINGS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 KINGS BAY RD
ST MARYS GA
31558-3155
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 912-265-3833
  • Fax:
Mailing address:
  • Phone: 763-268-4286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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