Healthcare Provider Details

I. General information

NPI: 1992216394
Provider Name (Legal Business Name): RIO FAMILY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SR 325 SOUTH
RIO GRANDE OH
45674
US

IV. Provider business mailing address

PO BOX 318
RIO GRANDE OH
45674-0318
US

V. Phone/Fax

Practice location:
  • Phone: 740-245-0033
  • Fax: 740-245-0031
Mailing address:
  • Phone: 740-645-3620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number12484
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12484
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number12484
License Number StateOH

VIII. Authorized Official

Name: SHERRY LYNN RUSSELL
Title or Position: CNP/OWNER
Credential: NURSE PRACTITIONER
Phone: 740-245-0033