Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Hydration and Functional Health LLC

Organization Infusion Therapy Clinic/Center · NPI 1558128314

Revive Hydration and Functional Health LLC is an Infusion Therapy Clinic/Center in Douglas, Georgia. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1150 Ward Street Ext W Ste B1
Douglas, GA 31533-1913
Phone: (912) 720-5450
Fax: (866) 611-2696
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X

Record details

NPI number1558128314
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bobby Guess — Owner · (912) 720-5450
NPI enumeratedFebruary 28, 2024
Last updated in NPPESFebruary 28, 2024
Certification dateFebruary 28, 2024
Mailing address1150 Ward Street Ext W Ste B1, Douglas, GA 31533-1913

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