Healthcare Provider Details
I. General information
NPI: 1487350419
Provider Name (Legal Business Name): RC CONSOLIDATED SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7010 PENNY CT
RANCHO CUCAMONGA CA
91739-2565
US
IV. Provider business mailing address
PO BOX 914
RANCHO CUCAMONGA CA
91729-0914
US
V. Phone/Fax
- Phone: 909-977-1945
- Fax:
- Phone: 310-808-2224
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRAD
JOHNSON
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 909-977-1945