MEDICARE: RUMAR HEALTHCARE

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	208D00000X	General Practice Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1588538417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUMAR HEALTHCARE

Provider Business Mailing Address
First Line	:	105 S 97TH ST APT G204
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85208-1962
Country	:	US
Telephone Number	:	860-884-6285
Fax Number	:	860-884-6285

Provider Business Practice Location Address
First Line	:	105 S 97TH ST APT G204
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85208-1962
Country	:	US
Telephone Number	:	860-884-6285
Fax Number	:	860-884-6285

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RUTH YAMILE MARCELLUS
Credential	:	PA
Telephone Number	:	860-884-6285

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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