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General NPI Number Information
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NPI Number | 1871241034
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Entity Type | Organization
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Legal Business Name | RUTH ANN'S DESSERTS LLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 18020 JOHN AVE
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-5018
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Country | US
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Telephone | 773-993-2671
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Fax |
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Provider Business Mailing Address
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Address Line | 18020 JOHN AVE
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-5018
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Country | US
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Telephone | 773-993-2671
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MISS SHONDA S RHODES
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Credential |
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Telephone | 773-993-2671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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