Provider Demographics
NPI:1043230956
Name:RICHLAND INTERNISTS, INC.
Entity Type:Organization
Organization Name:RICHLAND INTERNISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-747-3400
Mailing Address - Street 1:2293 VILLAGE MALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-747-3400
Mailing Address - Fax:419-747-3408
Practice Address - Street 1:2293 VILLAGE MALL DRIVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-747-3400
Practice Address - Fax:419-747-3408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOH2177817Medicaid
OHHA4019472Medicare ID - Type Unspecified
OHOH2177817Medicaid