Healthcare Provider Details

I. General information

NPI: 1679586010
Provider Name (Legal Business Name): RINEHART FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 W. FIRST STREET
SPRINGFIELD OH
45504-4264
US

IV. Provider business mailing address

2816 W. FIRST STREET
SPRINGFIELD OH
45504-4264
US

V. Phone/Fax

Practice location:
  • Phone: 937-322-8977
  • Fax: 937-322-5837
Mailing address:
  • Phone: 937-322-8977
  • Fax: 937-322-5837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA TACKETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 937-322-8977