Provider Demographics
NPI:1568453561
Name:RVL MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:RVL MEDICAL SUPPLIES INC.
Other - Org Name:RVL MEDICAL SUPPLIES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANYANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-682-4700
Mailing Address - Street 1:724 CULEBRA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201
Mailing Address - Country:US
Mailing Address - Phone:210-682-4700
Mailing Address - Fax:210-682-4704
Practice Address - Street 1:724 CULEBRA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201
Practice Address - Country:US
Practice Address - Phone:210-682-4700
Practice Address - Fax:210-682-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0046050332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3944790001Medicare ID - Type Unspecified