Provider Demographics
NPI:1447578075
Name:RCHP - OTTUMWA LLC
Entity type:Organization
Organization Name:RCHP - OTTUMWA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-844-9849
Mailing Address - Street 1:1 PENNSYLVANIA PL
Mailing Address - Street 2:APT. 2
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2171
Mailing Address - Country:US
Mailing Address - Phone:641-684-3136
Mailing Address - Fax:641-682-1237
Practice Address - Street 1:1 PENNSYLVANIA PL
Practice Address - Street 2:APT. 2
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2171
Practice Address - Country:US
Practice Address - Phone:641-684-3136
Practice Address - Fax:641-682-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
167176Medicare PIN