Healthcare Provider Details

I. General information

NPI: 1437493657
Provider Name (Legal Business Name): RVC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18537 US 84/285 SUITE D
ESPANOLA NM
87532
US

IV. Provider business mailing address

18537 US 84/285 SUITE D
ESPANOLA NM
87532
US

V. Phone/Fax

Practice location:
  • Phone: 505-753-8374
  • Fax:
Mailing address:
  • Phone: 505-753-8374
  • Fax: 505-747-3041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA J. ROMERO
Title or Position: PRESIDENT
Credential:
Phone: 505-753-8374