Provider Demographics
NPI:1245772375
Name:RANADA LLC
Entity Type:Organization
Organization Name:RANADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SENIKA
Authorized Official - Middle Name:RANADA
Authorized Official - Last Name:CHANNELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-506-2494
Mailing Address - Street 1:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45501
Mailing Address - Country:US
Mailing Address - Phone:614-506-2494
Mailing Address - Fax:
Practice Address - Street 1:17 VANDERBILT DRIVE APT G
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324
Practice Address - Country:US
Practice Address - Phone:614-506-2494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2357920302F00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization