Provider Demographics
NPI:1457234478
Name:EIFERT, RICHARD BRENT
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRENT
Last Name:EIFERT
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 SOUTHLINE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-3201
Mailing Address - Country:US
Mailing Address - Phone:513-496-9110
Mailing Address - Fax:
Practice Address - Street 1:713 SOUTHLINE DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-3201
Practice Address - Country:US
Practice Address - Phone:513-496-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty