MEDICARE: MARK RUTLEDGE

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1588426951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK RUTLEDGE

Provider Business Mailing Address
First Line	:	5102 CATO ST
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1414
Country	:	US
Telephone Number	:	216-372-1746
Fax Number	:

Provider Business Practice Location Address
First Line	:	5102 CATO ST
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1414
Country	:	US
Telephone Number	:	216-372-1746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2024
Last Update Date	:	01/30/2024

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Directions to “ MARK RUTLEDGE ” Practice Location

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