LIFERX
NPI 1104186667
Clinic/Center - Health Service in Bloomington, IL
Active since May 17, 2012
About Liferx NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFERX (NPI 1104186667) is a healthcare organization registered as a health service in Bloomington, Illinois and active in the NPI registry since May 2012. The organization lists Shawn Christopher Snider, Owner, as its authorized official.
NPPES Registry Identity
NPI1104186667
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameREJUV INTEGRATIVE MEDICAL PRACTICE SHAWN C SNIDER
Location Address405 N HERSHEY RDBloomington, IL 61704-3527
Mailing Address405 N Hershey RdBloomington, IL 61704-3527 · (309) 622-3002 · Fax (309) 263-4611
Phone(309) 622-3002
Fax(309) 263-4611
Organization SubpartNo
Authorized OfficialShawn Christopher SniderOwner · (309) 622-3002
Enumeration DateMay 17, 2012
✔ NPI 1104186667 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in IL · 036.110856
405 N HERSHEY RD, Bloomington, IL 61704
Other Names 1
Doing Business AsLiferx
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104186667, enumerated as an "organization" on May 17, 2012.
The provider is located at 405 N HERSHEY RD BLOOMINGTON, IL 61704 and the phone number is (309) 622-3002.
Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.
