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General NPI Number Information
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NPI Number | 1245028950
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Entity Type | Organization
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Legal Business Name | REA MEDICAL, LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1965 NEWARK GRANVILLE RD
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City | GRANVILLE
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State | OH
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Zip | 43023-9171
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Country | US
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Telephone | 740-457-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 8800 FRAZEYSBURG RD
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City | DRESDEN
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State | OH
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Zip | 43821-9473
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Country | US
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Telephone | 740-973-1394
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER (COO)
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Name | CHARLES SCHABEN
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Credential |
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Telephone | 740-457-4583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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