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NPI Code Detail

MEDICARE: MR. JACOB RUDE

MEDICARE: MR. JACOB RUDE
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1760299473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACOB RUDE
Provider Business Mailing Address
First Line : 3248 WARSAW ST
Second Line :
City : TOLEDO
State : OH
Zip : 43608-1852
Country : US
Telephone Number : 419-829-7328
Fax Number : 419-244-9906
Provider Business Practice Location Address
First Line : 3248 WARSAW ST
Second Line :
City : TOLEDO
State : OH
Zip : 43608-1852
Country : US
Telephone Number : 419-819-7328
Fax Number : 419-244-9906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2024
Last Update Date : 12/16/2024

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