Healthcare Provider Details

I. General information

NPI: 1811183767
Provider Name (Legal Business Name): RIELAG VENUTRES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 09/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 EBENEZER RD
CINCINNATI OH
45248-1503
US

IV. Provider business mailing address

4041 EBENEZER RD
CINCINNATI OH
45248-1503
US

V. Phone/Fax

Practice location:
  • Phone: 513-708-3963
  • Fax: 513-574-0692
Mailing address:
  • Phone: 513-708-3963
  • Fax: 513-574-0692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH A. RIELAG
Title or Position: OWNER
Credential:
Phone: 513-708-3963