Organization
REVIVE SPA HYDRATION PLLC
Active
Parent organization
SECURE ALLIANCE PS LLC
Other names
Revive Spa Hydration
Organization subpart
Yes
Provider details
NPI number
Legal business name
SECURE ALLIANCE PS LLC
Authorized official
MRS. BETH ANN SCHUBERT RN (OWNER)
(253) 257-8340
Entity
Organization
Contact information
Practice address
17609 29TH AVENUE CT E, TACOMA, WA 98445-4622
(253) 257-8340
Mailing address
17609 29TH AVENUE CT E, TACOMA, WA 98445-4622
(253) 257-8340
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609417203
—
WA
Enumeration date
08/04/2021
Last updated
08/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us