MEDICARE: MR. CHARLES WALTER RUITER III

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	225XE0001X	Environmental Modification Occupational Therapist	B202009141071371	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801563432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES WALTER RUITER III

Provider Business Mailing Address
First Line	:	3355 PALMS CENTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5663
Country	:	US
Telephone Number	:	702-252-4069
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 PALMS CENTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5663
Country	:	US
Telephone Number	:	702-252-4069
Fax Number	:

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

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	08/23/2021

Similar Medicare Providers

1770245698 — RUITER CONSTRUCTION, LLC
Practice Location Address:

3355 PALMS CENTER DR
LAS VEGAS, NV
89103-5663

Practice Phone: 702-252-4069
Practice Fax:

1194156745 — UNITED RESPIRATORY CARE
Practice Location Address:

5745 S FORT APACHE RD , SUITE B
LAS VEGAS, NV
89148-5663

Practice Phone: 702-489-8600
Practice Fax: 702-489-8601

1134660137 — NEW IMAGE MEDICAL INC.
Practice Location Address:

2610 S JONES BLVD STE B
LAS VEGAS, NV
89146-5663

Practice Phone: 877-302-8630
Practice Fax:

1447728373 — GOODWILL PHARMACY INC.
Practice Location Address:

2610 S. JONES BLVD , SUITE 3
LAS VEGAS, NV
89146-5663

Practice Phone: 702-213-3102
Practice Fax: 702-940-7580

1326873662 — ADDE PCA CARE, INC
Practice Location Address:

2610 S JONES BLVD STE D
LAS VEGAS, NV
89146-5663

Practice Phone: 725-599-3880
Practice Fax: 702-213-9064

1356235196 — TINA HOANG
Practice Location Address:

5663 FOXGLOVE FIELD ST
LAS VEGAS, NV
89130-1601

Practice Phone: 702-421-2400
Practice Fax:

Directions to “ MR. CHARLES WALTER RUITER III ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.