Healthcare Provider Details

I. General information

NPI: 1114832151
Provider Name (Legal Business Name): MAX REV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 GEORGETOWN RD APT 1207
FRANKFORT KY
40601-6607
US

IV. Provider business mailing address

445 W NEES AVE APT 263
FRESNO CA
93711-6899
US

V. Phone/Fax

Practice location:
  • Phone: 360-854-4258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: SHUBHKARAN SHUBHKARAN
Title or Position: CEO
Credential:
Phone: 360-854-4258