Healthcare Provider Details

I. General information

NPI: 1194643668
Provider Name (Legal Business Name): R&K SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9633 RUSTLERS TRL
MENAN ID
83434-5231
US

IV. Provider business mailing address

9633 RUSTLERS TRL
MENAN ID
83434-5231
US

V. Phone/Fax

Practice location:
  • Phone: 208-881-8240
  • Fax:
Mailing address:
  • Phone: 208-881-8240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: RYAN GARY STATEN
Title or Position: PRESIDENT
Credential:
Phone: 208-881-8240