Organization
BLUE IV LLC
Active
Other names
Revive IV, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BOYLE (COO)
(914) 512-1793
Entity
Organization
Contact information
Practice address
32 LONDON BRIDGE RD, WINDHAM, NH 03087-1786
(612) 367-7806
Mailing address
32 LONDON BRIDGE RD, WINDHAM, NH 03087-1786
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
07/29/2024
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