=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376429670
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RELATYV MOBILE MEDICAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2025
-----------------------------------------------------
Last Update Date | 08/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 BISBEE RD
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19711-5607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-914-1070
-----------------------------------------------------
Fax | 877-285-0477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4140 E BASELINE RD STE 101
-----------------------------------------------------
City | MESA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85206-4413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-953-2175
-----------------------------------------------------
Fax | 877-285-0477
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CONTRACTING MANAGER
-----------------------------------------------------
Name | JANICE A COMPTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 830-832-9703
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246Z00000X
-----------------------------------------------------
Taxonomy Name | Other Specialist/Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------