Provider Demographics
NPI:1295960789
Name:REVENUE CARE LLC
Entity type:Organization
Organization Name:REVENUE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIDEOUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-782-2200
Mailing Address - Street 1:601 S 10TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-7027
Mailing Address - Country:US
Mailing Address - Phone:916-782-2200
Mailing Address - Fax:916-782-3101
Practice Address - Street 1:601 S 10TH ST STE 106
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-7027
Practice Address - Country:US
Practice Address - Phone:916-782-2200
Practice Address - Fax:916-782-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization