Provider Demographics
NPI:1235559808
Name:RUTHS KINGDOM IHS LLC
Entity Type:Organization
Organization Name:RUTHS KINGDOM IHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-828-6273
Mailing Address - Street 1:5356 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-3409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:314-338-6394
Practice Address - Street 1:5356 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-3409
Practice Address - Country:US
Practice Address - Phone:314-828-6273
Practice Address - Fax:314-338-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care