Provider Demographics
NPI:1164146148
Name:DURANT, RUBEN KAREEM
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:KAREEM
Last Name:DURANT
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 1:6410 MAYFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4402
Mailing Address - Country:US
Mailing Address - Phone:513-508-1976
Mailing Address - Fax:
Practice Address - Street 1:6410 MAYFLOWER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-4402
Practice Address - Country:US
Practice Address - Phone:513-508-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTH188215253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care