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

Revive Infusion Clinic, LLC

Organization General Practice Physician · NPI 1457226789

Revive Infusion Clinic, LLC is a General Practice Physician in Eagle River, Alaska. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

19332 War Admiral Rd
Eagle River, AK 99577-8482
Phone: (417) 793-3935
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Infusion Therapy Clinic/Center (primary) Taxonomy 261QI0500X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1457226789
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Shannon — Owner · (417) 793-3935
NPI enumeratedOctober 7, 2025
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025
Mailing address19332 War Admiral Rd, Eagle River, AK 99577-8482

Other providers in Eagle River