Synergy Revitalize Med & Spa Center
LBN: Synergy Revitalize Medical Center, Llc
Synergy Revitalize Med & Spa Center is an health care organization with primary practice located at 5457 Twin Knolls Rd Ste 300-S11 , Columbia MD 21045-3259. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is the primary health care specialty.
Synergy Revitalize Medical Center, Llc can be contacted via phone (216) 357-8977, or through Taylor, Elaine M via phone (301) 602-4658.
Contact Information
Primary practice address
5457 Twin Knolls Rd Ste 300-S11
Columbia MD 21045-3259
Phone: (216) 357-8977
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ||
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X |
Profile Details
| NPI number | 1558006957 |
|---|---|
| LBN Legal business name | Synergy Revitalize Medical Center, Llc |
| DBA Doing business as | Synergy Revitalize Med & Spa Center |
| Authorized official | Taylor, Elaine M |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 29th, 2022 |
| Last updated | May 8th, 2024 - about 6 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558006957 | NPPES |
| Maryland | MEDICAID | 598055100 | |
| Maryland | Other | 1295045755 |
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