Healthcare Provider Details

I. General information

NPI: 1285567966
Provider Name (Legal Business Name): RVOHRX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W MAIN ST STE 356
BOISE ID
83702-5740
US

IV. Provider business mailing address

1101 RED VENTURES DR
FORT MILL SC
29707-5005
US

V. Phone/Fax

Practice location:
  • Phone: 208-208-6525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA ASTER
Title or Position: ATTORNEY
Credential:
Phone: 877-744-7221