Healthcare Provider Details
I. General information
NPI: 1619806593
Provider Name (Legal Business Name): RESTORE HEALTH SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2008 BREMO RD STE 110
RICHMOND VA
23226-2443
US
IV. Provider business mailing address
261 OLD YORK RD FL 7
JENKINTOWN PA
19046-3706
US
V. Phone/Fax
- Phone: 601-907-3796
- Fax:
- Phone: 601-907-3796
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RAVI
LNU
Title or Position: CEO
Credential:
Phone: 601-907-3769