Provider Demographics
NPI:1497928071
Name:RGR, LLC
Entity Type:Organization
Organization Name:RGR, LLC
Other - Org Name:KIDCARE NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-677-2700
Mailing Address - Street 1:2880 W. OAKLAND PARK BLVD.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1350
Mailing Address - Country:US
Mailing Address - Phone:954-677-2700
Mailing Address - Fax:954-677-2800
Practice Address - Street 1:2880 W. OAKLAND PARK BLVD.
Practice Address - Street 2:SUITE 215
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-1350
Practice Address - Country:US
Practice Address - Phone:954-677-2700
Practice Address - Fax:954-677-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993020251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993020OtherHOME HEALTH LISCENSE