Provider Demographics
NPI:1346325651
Name:RJ HEALTHCARE
Entity Type:Organization
Organization Name:RJ HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAGWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-781-0086
Mailing Address - Street 1:3330 FLO LOR DR
Mailing Address - Street 2:11D
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-4712
Mailing Address - Country:US
Mailing Address - Phone:330-781-0046
Mailing Address - Fax:330-788-2124
Practice Address - Street 1:3610 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-2047
Practice Address - Country:US
Practice Address - Phone:330-781-0046
Practice Address - Fax:330-788-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2331408Medicaid
4091354Medicare ID - Type Unspecified
OH2331408Medicaid