Provider Demographics
NPI:1447966676
Name:POLK, RICH
Entity type:Individual
Prefix:
First Name:RICH
Middle Name:
Last Name:POLK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-1145
Mailing Address - Country:US
Mailing Address - Phone:330-807-5674
Mailing Address - Fax:
Practice Address - Street 1:720 NORTH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44131-1145
Practice Address - Country:US
Practice Address - Phone:330-807-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemaker