Provider Demographics
NPI:1427230424
Name:RVH INCORPORATED
Entity type:Organization
Organization Name:RVH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:VAL
Authorized Official - Last Name:HARWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-571-2200
Mailing Address - Street 1:11616 S STATE ST
Mailing Address - Street 2:SUITE 1502
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7125
Mailing Address - Country:US
Mailing Address - Phone:801-571-2200
Mailing Address - Fax:801-816-1048
Practice Address - Street 1:11616 S STATE ST
Practice Address - Street 2:SUITE 1502
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7125
Practice Address - Country:US
Practice Address - Phone:801-571-2200
Practice Address - Fax:801-816-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT172703-1202302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005710001Medicare PIN