Provider Demographics
NPI:1477645455
Name:RICH HEALTH AND WELLNESS INC
Entity Type:Organization
Organization Name:RICH HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-497-0000
Mailing Address - Street 1:4410 EXECUTIVE CIR NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2983
Mailing Address - Country:US
Mailing Address - Phone:330-497-0000
Mailing Address - Fax:330-497-8089
Practice Address - Street 1:4410 EXECUTIVE CIR NW
Practice Address - Street 2:SUITE B
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2983
Practice Address - Country:US
Practice Address - Phone:330-497-0000
Practice Address - Fax:330-497-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRI9352161Medicare ID - Type Unspecified