MEDICARE: GV PARTNERS, 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

General Provider Information

NPI Number	:	1912356528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GV PARTNERS, LLC

Provider Business Mailing Address
First Line	:	2865 SUNRISE BLVD
Second Line	:	SUITE 102
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-6538
Country	:	US
Telephone Number	:	916-302-4243
Fax Number	:	916-302-4730

Provider Business Practice Location Address
First Line	:	2865 SUNRISE BLVD
Second Line	:	SUITE 102
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-6538
Country	:	US
Telephone Number	:	916-302-4243
Fax Number	:	916-302-4730

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. GALE RANDALL DAVIS
Credential	:
Telephone Number	:	916-302-4243

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	06/06/2016

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