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NPI Code Detail

MEDICARE: BERTHA JEAN RUFFIN

MEDICARE:   BERTHA JEAN RUFFIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1548858715
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERTHA JEAN RUFFIN
Provider Business Mailing Address
First Line : 425 34TH ST NW
Second Line :
City : CANTON
State : OH
Zip : 44709-3023
Country : US
Telephone Number : 330-933-8102
Fax Number :
Provider Business Practice Location Address
First Line : 425 34TH ST NW
Second Line :
City : CANTON
State : OH
Zip : 44709-3023
Country : US
Telephone Number : 330-933-8102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2021
Last Update Date : 01/04/2021

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Directions to “ BERTHA JEAN RUFFIN ” Practice Location

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