Healthcare Provider Details

I. General information

NPI: 1982443701
Provider Name (Legal Business Name): REALIZABLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 05/21/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 COMPTON RD
CINCINNATI OH
45231-3428
US

IV. Provider business mailing address

1580 COMPTON RD
CINCINNATI OH
45231-3428
US

V. Phone/Fax

Practice location:
  • Phone: 513-692-0078
  • Fax:
Mailing address:
  • Phone: 513-692-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MS. QUINETTA TUBBS
Title or Position: PRESIDENT
Credential:
Phone: 513-692-0078