Provider Demographics
NPI: | 1033390067 |
---|---|
Name: | RIZZUTO'S INC |
Entity Type: | Organization |
Organization Name: | RIZZUTO'S INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRES |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RON |
Authorized Official - Middle Name: | FRANK |
Authorized Official - Last Name: | RIZZUTO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 509-483-5140 |
Mailing Address - Street 1: | 4407 N DIVISION ST |
Mailing Address - Street 2: | SUITE 106 |
Mailing Address - City: | SPOKANE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 99207-1402 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 509-483-5140 |
Mailing Address - Fax: | 509-489-5102 |
Practice Address - Street 1: | 4407 N DIVISION ST |
Practice Address - Street 2: | SUITE 106 |
Practice Address - City: | SPOKANE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 99207-1600 |
Practice Address - Country: | US |
Practice Address - Phone: | 509-483-5140 |
Practice Address - Fax: | 509-489-5102 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-11-19 |
Last Update Date: | 2009-06-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WA | 9054735 | Medicaid | |
WA | 9054735 | Medicaid |