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NPI Code Detail

MEDICARE: RVP ENTERPRISES INC.

MEDICARE: RVP ENTERPRISES INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityALF145NE
2314000000XSkilled Nursing Facility204002NE

General Provider Information

NPI Number : 1588660138
Entity Type Code : Organization
Provider Name (Legal Business Name) : RVP ENTERPRISES INC.
Provider Business Mailing Address
First Line : 3501 DAKOTA AVE
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3641
Country : US
Telephone Number : 402-494-4273
Fax Number : 402-494-1267
Provider Business Practice Location Address
First Line : 3501 DAKOTA AVE
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3641
Country : US
Telephone Number : 402-494-4273
Fax Number : 402-494-1267
Authorized Official
Title or Position : CONTROLLER
Name : JASON HARNISCH
Credential :
Telephone Number : 402-753-6101
Provider Enumeration Date : 06/27/2005
Last Update Date : 05/28/2015

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Directions to “RVP ENTERPRISES INC. ” Practice Location

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