Provider Demographics
NPI:1659062727
Name:RVA SURGICAL INC
Entity Type:Organization
Organization Name:RVA SURGICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:CSA-LSA
Authorized Official - Phone:804-306-5514
Mailing Address - Street 1:7211 W KIMBERLY WAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5858
Mailing Address - Country:US
Mailing Address - Phone:804-306-5514
Mailing Address - Fax:
Practice Address - Street 1:7211 W KIMBERLY WAY
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5858
Practice Address - Country:US
Practice Address - Phone:804-306-5514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty