Healthcare Provider Details
I. General information
NPI: 1629456827
Provider Name (Legal Business Name): RNJ GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5320 SPORT CLUB RUN
SUFFOLK VA
23435-4224
US
IV. Provider business mailing address
PO BOX 9587
CHESAPEAKE VA
23321-9587
US
V. Phone/Fax
- Phone: 757-483-8243
- Fax:
- Phone: 757-483-8243
- Fax:
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 | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
NEAL
JOHNSON
Title or Position: OWNER
Credential:
Phone: 757-483-8243