1497897334 NPI number — PAUL J RUWE INC

Table of content: (NPI 1497897334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497897334 NPI number — PAUL J RUWE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAUL J RUWE 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:
6
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:
1497897334
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 LANDMARK DR
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41073-1393
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-291-8665
Provider Business Mailing Address Fax Number:
859-291-2308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 LANDMARK DR
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41073-1393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-291-8665
Provider Business Practice Location Address Fax Number:
859-291-2308
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZEIS
Authorized Official First Name:
JEANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER,AO
Authorized Official Telephone Number:
859-291-8665

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  P06096 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2031909 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54030150 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90230194 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com