Provider Demographics
NPI:1770210643
Name:REHAB JV LLC
Entity type:Organization
Organization Name:REHAB JV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-342-4349
Mailing Address - Street 1:2000 WILKES RIDGE DR # 1057
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7632
Mailing Address - Country:US
Mailing Address - Phone:804-578-6369
Mailing Address - Fax:804-578-6378
Practice Address - Street 1:2000 WILKES RIDGE DR # 1057
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7632
Practice Address - Country:US
Practice Address - Phone:804-578-6369
Practice Address - Fax:804-578-6378
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHAB JV, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201004951OtherBOARD OF PHARMACY
VAFS9764564OtherDEA