Provider Demographics
NPI:1033980511
Name:RUSH, ERIC W
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:RUSH
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 1:118 W TULANE RD APT C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1941
Mailing Address - Country:US
Mailing Address - Phone:513-720-7969
Mailing Address - Fax:
Practice Address - Street 1:118 W TULANE RD APT C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1941
Practice Address - Country:US
Practice Address - Phone:513-720-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.518828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse