Healthcare Provider Details

I. General information

NPI: 1922945146
Provider Name (Legal Business Name): REVMEDIX DEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 NE NEWPORT DR
LEES SUMMIT MO
64064-2044
US

IV. Provider business mailing address

643 NE NEWPORT DR
LEES SUMMIT MO
64064-2044
US

V. Phone/Fax

Practice location:
  • Phone: 640-642-0446
  • Fax:
Mailing address:
  • Phone: 640-642-0446
  • 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: MR. TALHA HASEEB PARACHA
Title or Position: CEO
Credential:
Phone: 816-493-6628