1942392782 NPI number — DEARBORN MEDICAL & REHABILITATION CENTER

Table of content: SHELLY R. RUFF CRNA (NPI 1912948852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942392782 NPI number — DEARBORN MEDICAL & REHABILITATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEARBORN MEDICAL & REHABILITATION CENTER
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:
1942392782
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23917 FORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEARBORN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48128-1207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-724-0224
Provider Business Mailing Address Fax Number:
313-724-0232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23917 FORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEARBORN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48128-1207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-724-0224
Provider Business Practice Location Address Fax Number:
313-724-0232
Provider Enumeration Date:
09/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GUILARTE
Authorized Official First Name:
CARIDAD
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
313-724-0224

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com