Healthcare Provider Details

I. General information

NPI: 1285256024
Provider Name (Legal Business Name): RCT HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W MESA AVE
GALLUP NM
87301-6335
US

IV. Provider business mailing address

5401 E VAN BUREN ST UNIT 3054
PHOENIX AZ
85008-3469
US

V. Phone/Fax

Practice location:
  • Phone: 800-550-8603
  • Fax:
Mailing address:
  • Phone: 832-209-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARMAKE A MOHAMUD
Title or Position: MANAGER
Credential: HOME HEALTH CARE
Phone: 614-218-9817