Provider Demographics
NPI:1386440535
Name:RECOVERY RX LLC
Entity type:Organization
Organization Name:RECOVERY RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:WAYMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-421-2754
Mailing Address - Street 1:3046 N 3422 E
Mailing Address - Street 2:
Mailing Address - City:KIMBERLY
Mailing Address - State:ID
Mailing Address - Zip Code:83341-5362
Mailing Address - Country:US
Mailing Address - Phone:208-421-2754
Mailing Address - Fax:
Practice Address - Street 1:738 N COLLEGE RD STE B
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3386
Practice Address - Country:US
Practice Address - Phone:208-735-3619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty