Healthcare Provider Details

I. General information

NPI: 1912282120
Provider Name (Legal Business Name): RK WOOD PRODUCTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 YOUNGSTOWN POLAND RD
STRUTHERS OH
44471-1105
US

IV. Provider business mailing address

5354 NEW CASTLE RD
LOWELLVILLE OH
44436-9532
US

V. Phone/Fax

Practice location:
  • Phone: 330-755-7090
  • Fax: 330-755-7092
Mailing address:
  • Phone: 330-755-7090
  • Fax:

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 Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH ROBERT DEMETRO
Title or Position: PRESIDENT
Credential:
Phone: 330-755-7090