Healthcare Provider Details
I. General information
NPI: 1528297025
Provider Name (Legal Business Name): RHINO31 INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 S 3RD ST
WATERVILLE OH
43566-1414
US
IV. Provider business mailing address
13 S 3RD ST
WATERVILLE OH
43566-1414
US
V. Phone/Fax
- Phone: 419-794-1090
- Fax: 419-794-4731
- Phone: 419-794-1090
- Fax: 419-794-4731
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
J.
HOORMAN
Title or Position: OWNER
Credential:
Phone: 419-794-1090