Healthcare Provider Details

I. General information

NPI: 1144879974
Provider Name (Legal Business Name): RUBY'S PRIVATE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 REDMOND CIR NW STE 800
ROME GA
30165-1463
US

IV. Provider business mailing address

1850 REDMOND CIR NW STE 800
ROME GA
30165-1463
US

V. Phone/Fax

Practice location:
  • Phone: 706-237-6359
  • Fax:
Mailing address:
  • Phone: 706-237-6359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA KING
Title or Position: CHIEF EXECUTIVE OFFICER/OWNER
Credential:
Phone: 706-853-8282