MEDICARE: RTVT ENTERPRISES LLC

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
1	253Z00000X	In Home Supportive Care Agency	HCO11655	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HCO11655	OTHER	VA	COMMONWEALTH OF VIRGINIA VIRGINIA DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1700183779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RTVT ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	4870 SADLER RD
Second Line	:	SUITE 300
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-6294
Country	:	US
Telephone Number	:	804-368-3200
Fax Number	:	888-761-8316

Provider Business Practice Location Address
First Line	:	4870 SADLER RD
Second Line	:	SUITE 300
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-6294
Country	:	US
Telephone Number	:	804-368-3200
Fax Number	:	888-761-8316

Authorized Official
Title or Position	:	OWNER/CARE COORDINATOR
Name	:	LYNN A HANCOCK
Credential	:
Telephone Number	:	804-368-3200

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	02/28/2011

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Directions to “RTVT ENTERPRISES LLC ” Practice Location

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