1245413764 NPI number — RUFUS A REUBEN MD INTERNAL MEDICINE & GERIATRICS INC

Table of content: (NPI 1245413764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245413764 NPI number — RUFUS A REUBEN MD INTERNAL MEDICINE & GERIATRICS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUFUS A REUBEN MD INTERNAL MEDICINE & GERIATRICS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245413764
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 GRAHAM RD
Provider Second Line Business Mailing Address:
SUITE #4
Provider Business Mailing Address City Name:
CUYAHOGA FALLS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44223-2259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-926-9409
Provider Business Mailing Address Fax Number:
330-926-9428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 GRAHAM RD
Provider Second Line Business Practice Location Address:
SUITE #4
Provider Business Practice Location Address City Name:
CUYAHOGA FALLS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44223-2259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-926-9409
Provider Business Practice Location Address Fax Number:
330-926-9428
Provider Enumeration Date:
12/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REUBEN
Authorized Official First Name:
RUFUS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
330-926-9409

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NE9999 . This is a "MEDICAL MUTUAL OF OMAHA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: QG05263 . This is a "HEALTH PLAN UPPER OH VALL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000323215 . This is a "ANTHEM BLUE CROSS/BLUE SH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 33678027400 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 406165 . This is a "WELLCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0975324 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 336780274015 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0005670529 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1245413764 . This is a "TRICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 110235464 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 729278 . This is a "BUCKEYE COMM. HEALTH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000204847 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: C002051273005 . This is a "UH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com