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General NPI Number Information
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NPI Number | 1255916987
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Entity Type | Organization
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Legal Business Name | REVIVE HIVE COVID-19 RAPID TESTING CENTER
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 4700 S MCCLINTOCK DR STE 140
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City | TEMPE
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State | AZ
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Zip | 85282-7375
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Country | US
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Telephone | 480-851-6309
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 S MCCLINTOCK DR STE 140
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City | TEMPE
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State | AZ
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Zip | 85282-7375
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Country | US
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Telephone | 480-851-6309
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MICAH PHILIPS
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Credential |
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Telephone | 602-717-8599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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